Endosaccular coiling is recognized as a feasible method for treating unruptured intracranial aneurysms (UIAs). We retrospectively reviewed cases of UIAs treated by coiling in the Japanese Registry of Neuroendovascular Therapy (JR-NET) 3, a nationwide survey of NET between 2010 and 2014, the beginning period of intracranial stents in Japan. Data were extracted for 6844 UIAs (6619 procedures) from 40,169 registered records of all NETs in the JR-NET 3 databases. The features of the aneurysms and procedures, immediate radiographic findings, procedure-related complications, and clinical outcomes at 30 days after the procedures were assessed. Of 6844 UIAs, 81.8% were located in the anterior circulation. The mean patient age was 61.3 years (72.4% females). Compared with the preceding JR-NET 1 and 2, there were significant increases (P <0.05) in the rates of the following in JR-NET 3: wide-necked and small UIAs measuring <10 mm (from 56.4% to 58.8%), adjunctive techniques (54.8% to 71.8%), and stent usage (1.1% to 22.1%). Both pre- (85.6% to 96.7%) and post-procedural (84.0% to 94.6%) antiplatelet therapy were more frequently administered in JR-NET 3. Although procedure-related complication rates did not differ between the two groups, ischemic complication rates increased from 4.6% to 5.9%, leading to an increase in the 30-day morbidity (modified Rankin Scale >2) from 2.1% to 2.8%. In conclusion, introduction of neck-bridge stent was associated with an increase in cases of wide-necked aneurysms. However, the ischemic complication rate increased despite the greater use of periprocedural antiplatelet therapy.

译文

腔内盘绕术被认为是治疗未破裂颅内动脉瘤 (UIAs) 的可行方法。我们回顾性地回顾了在日本神经血管内治疗注册中心 (jr-net) 3中通过盘绕治疗的UIAs病例,该调查是对日本的净2010年和2014 (日本颅内支架的开始时期) 的全国性调查。从jr-net 3数据库中所有NET的40,169登记记录中提取6844 UIAs (6619程序) 的数据。评估了动脉瘤和手术的特征,影像学检查结果,手术相关并发症以及手术后30天的临床结局。在6844个UIAs中,81.8% 个位于前循环。患者平均年龄为61.3岁 (72.4% 名女性)。与之前的JR-NET 1和2相比,JR-NET 3中的以下比率显着增加 (P <0.05): 宽颈和小型UIAs测量 <10毫米 (从56.4% 到58.8%),辅助技术 (54.8% 到71.8%),和支架的使用 (1.1% 至22.1%)。在JR-NET 3中,术前 (85.6% 至96.7%) 和术后 (84.0% 至94.6%) 抗血小板治疗均更为频繁。尽管两组之间与手术相关的并发症发生率没有差异,但缺血性并发症发生率从4.6% 增加到5.9%,导致30天发病率从2.1% 增加到2.8% (改良Rankin量表> 2)。总之,颈桥支架的引入与宽颈动脉瘤病例的增加有关。然而,尽管更多地使用围手术期抗血小板治疗,缺血并发症发生率仍增加。

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