中国人群未破裂颅内动脉瘤的治疗策略：中国未破裂颅内动脉瘤治疗试验（ChTUIA）
Treatment strategies for unruptured intracranial aneurysms in the Chinese population: China Treatment Trial for Unruptured Intracranial Aneurysm (ChTUIA).
作者信息
Zheng Kaige, Wen Zheng, Wang Kaiwen, Mo Shaohua, Wu Jun, Chen Xiaolin, Zhao Bing, Liu Qingyuan, Wang Shuo
机构信息
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
出版信息
Chin Neurosurg J. 2025 Apr 3;11(1):8. doi: 10.1186/s41016-025-00394-7.
BACKGROUND
Intracranial aneurysm is a leading cause of subarachnoid hemorrhage and affects approximately 7% of the Chinese population, posing a significant public health concern. Due to the lack of a national cohort of unruptured intracranial aneurysms (UIAs) in China, optimal surgical management for UIAs remain insufficiently explored.
METHODS
The China Treatment Trial for Unruptured Intracranial Aneurysm (ChTUIA) is a national, prospective, observational, multi-center registry study designed to identify optimal surgical management for UIAs in the Chinese population. Eligible patients were recruited from 83 regional neurological centers in China between December 2021 and December 2022. All patients will be followed up routinely for at least two years.
RESULTS
A total of 25,438 patients with UIAs have been enrolled in the study, of whom 9794 (38.5%) were male, with a median age of 59 years (interquartile range: 52-67 years). The mean follow-up period was 4.28 years (interquartile range: 2.86-6.37 years). Among the patients, 6,712 (26.4%) patients underwent microsurgical clipping, and 18,726 (73.6%) patients underwent endovascular treatment, including 3,017 (16.1%) receiving coil alone or balloon-assisted coiling, 11,431 (61.1%) underwent stent-assisted coiling, and 4,278 (22.8%) treated with flow diverters. Comprehensive data collection encompassed 874,890 demographic and clinical records, 42,109 radiological records, 13,528 hemodynamic records, and 12,727 biological records, with a lost-to-follow-up rate of 5.4% and a data-missing rate of 8.3%.
CONCLUSIONS
The ChTUIA study represents the first national prospective investigation into surgical management protocols and treatment trends toward UIAs in the Chinese population. This study will provide critical evidence to guide the clinical management of UIA patients.
TRIAL REGISTRATION
NCT05844163 ( https://clinicaltrials.gov/study/NCT05844163 ).
背景
颅内动脉瘤是蛛网膜下腔出血的主要原因，在中国约7%的人口中受其影响，这是一个重大的公共卫生问题。由于中国缺乏未破裂颅内动脉瘤（UIA）的全国性队列，对于UIA的最佳手术治疗方法仍未得到充分探索。
方法
中国未破裂颅内动脉瘤治疗试验（ChTUIA）是一项全国性、前瞻性、观察性、多中心注册研究，旨在确定中国人群中UIA的最佳手术治疗方法。符合条件的患者于2021年12月至2022年12月期间从中国83个地区神经中心招募。所有患者将接受至少两年的常规随访。
结果
共有25438例UIA患者纳入研究，其中男性9794例（38.5%），年龄中位数为59岁（四分位间距：52 - 67岁）。平均随访时间为4.28年（四分位间距：2.86 - 6.37年）。在这些患者中，6712例（26.4%）患者接受了显微手术夹闭，18726例（73.6%）患者接受了血管内治疗，其中3017例（16.1%）仅接受弹簧圈栓塞或球囊辅助弹簧圈栓塞，11431例（61.1%）接受了支架辅助弹簧圈栓塞，4278例（22.8%）采用血流导向装置治疗。综合数据收集涵盖874890份人口统计学和临床记录、42109份放射学记录、13528份血流动力学记录和12727份生物学记录，失访率为5.4%，数据缺失率为8.3%。
结论
ChTUIA研究是中国第一项针对人群中UIA手术治疗方案和治疗趋势的全国性前瞻性调查。本研究将为指导UIA患者的临床管理提供关键证据。
试验注册
NCT05844163（https://clinicaltrials.gov/study/NCT05844163）
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