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水凝胶弹簧圈治疗急性期颅内破裂动脉瘤的研究现状
薛盖茨,左乔,张小曦,唐海双,刘建民*
0
(海军军医大学(第二军医大学)长海医院神经外科, 上海 200433
*通信作者)
摘要:
血管内治疗是颅内破裂动脉瘤的重要治疗手段,然而较高的动脉瘤复发率和早期再出血率使其具有一定局限性。水凝胶弹簧圈是在传统的裸铂金弹簧圈的基础上进行水凝胶涂层修饰形成,可提高动脉瘤栓塞密度。多项随机对照试验证实水凝胶弹簧圈相较于裸铂金弹簧圈可降低动脉瘤复发率,但这些研究均基于所有状态的动脉瘤(包括破裂动脉瘤和未破裂动脉瘤),因此水凝胶弹簧圈是否可降低破裂动脉瘤复发率及早期再出血率目前尚无明确结论。本文对水凝胶弹簧圈治疗急性期颅内破裂动脉瘤的研究现状进行综述。
关键词:  颅内动脉瘤  破裂  水凝胶弹簧圈  动脉瘤复发  再出血
DOI:10.16781/j.0258-879x.2020.03.0309
投稿时间:2019-08-07修订日期:2019-11-06
基金项目:国家自然科学基金(81701136),国家卫生和计划生育委员会脑卒中防治工程"中国脑卒中高危人群干预适宜技术研究及推广项目"(GN-2016R0012).
Hydrogel coils in treatment of acute ruptured intracranial aneurysm: research status
XUE Gai-ci,ZUO Qiao,ZHANG Xiao-xi,TANG Hai-shuang,LIU Jian-min*
(Department of Neurosurgery, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Endovascular treatment with platinum coils has become a vital therapeutic option for ruptured intracranial aneurysms. However, the high aneurysm recurrence rates and early rebleeding cause some limitations. Hydrogel coil, which is consisted of a bare platinum coil and an inner core of hydrogel, is initially designed to improve the packing density of intracranial aneurysm. Several randomized controlled trials have demonstrated that hydrogel coils could significantly reduce the incidence of aneurysm recurrence compared with bare platinum coils. However, the inspiring conclusion was derived from those studies that included all states of intracranial aneurysms (ruptured and unruptured aneurysms). Whether hydrogel coils can reduce the recurrence and early rebleeding of ruptured intracranial aneurysms is still unclear. Therefore, this paper reviews the current status of research on hydrogel coils in the treatment of acute ruptured intracranial aneurysms.
Key words:  intracranial aneurysms  rupture  hydrogel coils  aneurysm recurrence  rebleeding