Aneurysm treatment with WEB in the cumulative population of two prospective, multicenter series: 3-year follow-up.
Aneurysm treatment with WEB in the cumulative population of two prospective, multicenter series: 3-year follow-up.
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DOI：
10.1136/neurintsurg-2020-016151
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发表时间：
2021-04
影响因子：
4.8
通讯作者：
Byrne J
中科院分区：
文献类型：
--
作者：
Pierot L;Szikora I;Barreau X;Holtmannspoetter M;Spelle L;Herbreteau D;Fiehler J;Costalat V;Klisch J;Januel AC;Weber W;Liebig T;Stockx L;Berkefeld J;Moret J;Molyneux A;Byrne J
宽颈分岔动脉瘤是一种血管内治疗方法，在中期随访中显示出高安全性和良好的疗效。虽然评估长期安全性对于确定是否发生影响晚期发病率和死亡率的延迟不良事件很重要，但评估动脉瘤闭塞的长期稳定性是最重要的一点。目前的分析报告了两项欧洲试验（WEBCAST （WEB临床评估囊内动脉瘤治疗）和WEBCAST-2）联合人群中WEB治疗的3年临床和解剖学结果。动脉瘤闭塞使用3级量表进行评估：完全闭塞、颈部残留和动脉瘤残留。安全人群包括79名患者。有效人群包括61个动脉瘤。动脉瘤位置以大脑中动脉32例（52.5%）、前交通动脉13例（21.3%）、基底动脉9例（14.8%）、颈内动脉末梢7例（11.5%）为主。2 - 3年内未发生与器械或手术相关的不良事件。3年时，31/61（50.8%）动脉瘤完全闭塞，20/61颈部残留（32.8%），10/61动脉瘤残留（16.4%）。1 ~ 3年间53/61（86.9%）动脉瘤闭塞改善或稳定，8/61（13.1%）动脉瘤闭塞恶化。6/61（9.8%）动脉瘤因完全闭塞而加重。3年再治疗率为11.4%。这一分析证实了WEB的高安全性。此外，有证据表明，83.6%的动脉瘤在充分闭塞（完全闭塞或颈部残留）的情况下，动脉瘤闭塞的稳定性很高。URL: http://www.clinicaltrials.gov。WEBCAST和WEBCAST-2：唯一标识符：NCT01778322。
WEB treatment is an endovascular approach for wide-neck bifurcation aneurysms that has demonstrated high safety and good efficacy in mid-term follow-up. While evaluating safety in the long term is important to determine if delayed adverse events occur affecting late morbidity and mortality, the most important point to evaluate is the long-term stability of aneurysm occlusion. The current analysis reports the 3-year clinical and anatomical results of WEB treatment in the combined population of two European trials (WEBCAST (WEB Clinical Assessment of Intrasaccular Aneurysm Therapy) and WEBCAST-2). Aneurysm occlusion was evaluated using a 3-grade scale: complete occlusion, neck remnant, and aneurysm remnant. The safety population comprised 79 patients. The efficacy population comprised 61 aneurysms. Aneurysm locations were middle cerebral artery in 32/61 aneurysms (52.5%), anterior communicating artery in 13/61 (21.3%), basilar artery in 9/61 (14.8%), and internal carotid artery terminus in 7/61 (11.5%). No adverse events related to the device or procedure occurred between 2 and 3 years. At 3 years, complete occlusion was observed in 31/61 (50.8%) aneurysms, neck remnant in 20/61 (32.8%), and aneurysm remnant in 10/61 (16.4%). Between 1 year and 3 years, aneurysm occlusion was improved or stable in 53/61 (86.9%) aneurysms and worsened in 8/61 (13.1%). Worsening was mostly from complete occlusion to neck remnant in 6/61 (9.8%) aneurysms. The retreatment rate at 3 years was 11.4%. This analysis confirms the high safety profile of WEB. Moreover, evidence demonstrates the great stability of aneurysm occlusion with adequate occlusion (complete occlusion or neck remnant) in 83.6% of aneurysms. URL: http://www.clinicaltrials.gov. WEBCAST and WEBCAST-2: Unique identifier: NCT01778322.
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影响因子：
4.8
作者：
Pierot, Laurent;Bannery, Christophe;Litre, Claude Fabien
通讯作者：
Litre, Claude Fabien
影响因子：
3.5
作者：
Shapiro, M.;Becske, T.;Nelson, P. K.
通讯作者：
Nelson, P. K.
影响因子：
4.8
作者：
Pierot L;Moret J;Barreau X;Szikora I;Herbreteau D;Turjman F;Holtmannspötter M;Januel AC;Costalat V;Fiehler J;Klisch J;Gauvrit JY;Weber W;Desal H;Velasco S;Liebig T;Stockx L;Berkefeld J;Molyneux A;Byrne J;Spelle L
通讯作者：
Spelle L
影响因子：
3.5
作者：
Hetts, S. W.;Turk, A.;McDougall, C.
通讯作者：
McDougall, C.
影响因子：
3.5
作者：
Raoult, Helene;Eugene, Francois;Gauvrit, Jean-Yves
通讯作者：
Gauvrit, Jean-Yves