Coil embolization yog ib qho kev kho mob zoo rau kev tsis sib haum xeeb ntawm lub hlwb aneurysms. Nws entails qhov chaw ntawm platinum coils nyob rau hauv lub aneurysm nrog lub hom phiaj ntawm kev cuam tshuam cov ntshav khiav, ua rau thrombosis, thiab tiv thaiv rupture. Cov cuab yeej sib txawv thiab cov txheej txheem yog siv thaum lub sijhawm ua haujlwm kom ntseeg tau tias muaj kev vam meej coil embolization. Ib qho ntawm cov cuab yeej no yog qhov nruab nrab catheter (IC), uas tau pom tias muaj txiaj ntsig zoo hauv kev ua tiav kev ua tiav ntawm cov hlab ntsha occlusion thiab ntom ntim.
IC yog ib tug ntev, hloov tau, thiab nyias catheter uas tau muab tso rau hauv niam txiv cov hlab ntsha thiab siab tshaj lub caj dab aneurysm. Nws ua hauj lwm raws li ib tug conduit rau coil xa thiab pab nyob rau hauv kev ruaj ntseg positioning. IC txhim kho coil xaiv, xa tawm, thiab ntim ntim, nrog rau tiv thaiv coil herniation thiab prolapse rau hauv niam txiv lub nkoj.
Ntau qhov kev tshawb fawb tau pom cov txiaj ntsig ntawm IC siv hauv coil embolization ntawm kev tsis sib haum xeeb ntawm lub paj hlwb aneurysms. Gaurav Goel et al. (2018) tau ua ib qho kev soj ntsuam rov qab ntawm 268 aneurysms kho nrog coil embolization thiab pom tias kev siv IC yog txuam nrog ntau dua ntawm kev ua tiav occlusion (OR=2.06, p=0.044) thiab ntom ntim (OR=2.08, p=0.025) dua li tsis muaj nws. Cov kws sau ntawv xaus lus tias kev siv IC yog ib qho kev kwv yees ntawm kev sib tw thiab kev ntim ntim thiab pom zoo nws cov kev siv niaj hnub siv hauv coil embolization.
Ib yam li ntawd, Naveen Naidu et al. (2014) tau ua txoj kev tshawb fawb yav tom ntej ntawm 162 aneurysms kho nrog coil embolization thiab pom tias kev siv IC tau cuam tshuam nrog kev ntim ntau dua (p<0.001) and complete occlusion rates (p=0.008). The authors suggested that IC facilitates coil manipulation and enhances visualization, leading to better coil packing and improved outcomes.
Tsis tas li ntawd, kev tshuaj xyuas thiab kev tshuaj ntsuam xyuas meta los ntawm Tara Garlinghouse li al. (2019) suav nrog 18 qhov kev tshawb fawb nrog tag nrho ntawm 3,704 tus neeg mob thiab pom tias kev siv IC cuam tshuam nrog ntau dua ntawm kev ua tiav occlusion (OR=1.31, p<0.001) and a lower risk of aneurysm recurrence (OR=0.75, p=0.049). The authors recommended the routine use of IC in coil embolization of unruptured cerebral aneurysms to achieve optimal outcomes.
Kev siv IC tsis yog yam tsis muaj kev pheej hmoo, thiab cov teeb meem xws li kev txiav cov hlab ntsha, thrombosis, rupture, thiab vasospasm tau raug tshaj tawm. Txawm li cas los xij, cov txiaj ntsig ntawm kev siv IC hauv kev ua tiav kev ua tiav ntawm qhov aneurysm occlusion thiab ntim ntim ntau dua qhov kev pheej hmoo, tshwj xeeb hauv kev paub txog tes. Kev cob qhia kom raug, kev kho cov txheej txheem, thiab ua raws li cov txheej txheem kev nyab xeeb yog tsim nyog los txo cov teeb meem cuam tshuam nrog kev siv IC.
Hauv cov ntsiab lus, kev siv IC yog ib qho cuab yeej tseem ceeb hauv kev ua tiav kev ua tiav coil embolization ntawm kev tsis sib haum xeeb ntawm lub paj hlwb aneurysms. Nws siv yog txuam nrog cov nqi siab dua ntawm kev ua tiav occlusion thiab ntom ntim, ua rau cov txiaj ntsig tau zoo dua. Los ntawm kev txhim kho coil xaiv, xa mus, thiab ntim ntim, kev siv IC muab lub tswv yim zoo thiab muaj txiaj ntsig zoo rau kev kho mob hlwb tsis zoo. Cov kev sim tshuaj ntxiv thiab kev tshawb fawb mus sij hawm ntev yuav tsum tau ua kom paub tseeb tias kev siv IC hauv coil embolization.