Preliminary experience with self-expanding closed-cell stent placement in small arteries less than 2 mm in diameter for the treatment of intracranial aneurysms
Preliminary experience with self-expanding closed-cell stent placement in small arteries less than 2 mm in diameter for the treatment of intracranial aneurysms
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DOI：
10.3171/2014.11.jns14435
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发表时间：
2015-06-01
影响因子：
4.1
通讯作者：
Kim, Yong Bae
中科院分区：
文献类型：
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作者：
Chung, Joonho;Suh, Sang Hyun;Kim, Yong Bae
目的本研究的目的是报告作者使用自膨式闭孔支架置入小动脉（直径<2mm）治疗颅内动脉瘤的初步经验。方法共研究31例患者。所有受试者均符合以下标准：1) 他们接受 Enterprise 支架用于治疗宽颈动脉瘤或夹层动脉瘤或作为支架抢救手术的一部分； 2) 他们在没有动脉粥样硬化狭窄的小载瘤动脉（直径 < 2 毫米）中部署了 Enterprise 支架。评估手术相关并发症和后续载瘤动脉的大小，以确保安全性和通畅性。 结果 有 16 个破裂动脉瘤和 15 个未破裂动脉瘤。 31 名患者中有 3 名（9.7%）出现了手术相关并发症，而且他们都没有症状。 27 名患者 (87.1%) 进行了随访血管造影（平均术后 15.5 个月）。具有 2 个锐角的载瘤动脉 (n = 4) 闭塞 3 例 (75.0%)，无锐角的载瘤动脉 (n = 13) 或 1 个锐角的载瘤动脉 (n = 6) 在后续血管造影中显示 100% 通畅。随访时载瘤动脉的尺寸（平均 1.72 +/- 0.30 毫米）与治疗前的尺寸（平均 1.59 +/- 0.26 毫米）之间存在显着差异（95% Cl -0.254 至 -0.009 毫米；p = 0.037，配对样本 t 检验）。 结论 在当前的系列中，自膨胀闭孔支架在小型支架中的部署动脉是安全的并且具有良好的通畅性，特别是当支架部署在没有锐角或只有 1 个锐角的载瘤动脉段中时。
OBJECT The purpose of this study was to report the authors' preliminary experience using self-expanding closed-cell stents deployed in small arteries (< 2 mm in diameter) to treat intracranial aneurysms.METHODS A total of 31 patients were studied. All subjects met the following criteria: 1) they received an Enterprise stent for treatment of a wide-necked aneurysm or a dissecting aneurysm or as part of a stent-salvage procedure; and 2) they had an Enterprise stent deployed in a small parent artery (< 2 mm in diameter) that had no atherosclerotic stenosis. Procedure-related complications and follow-up sizes of the parent arteries were evaluated for safety and patency.RESULTS There were 16 ruptured aneurysms and 15 unruptured aneurysms. Three (9.7%) of the 31 patients experienced procedure-related complications, and they all were asymptomatic. Follow-up angiography was performed in 27 patients (87.1%) (at a mean 15.5 months after surgery). Parent arteries with 2 acute angles (n = 4) were occluded in 3 cases (75.0%), and those with no acute angles (n = 13) or 1 acute angle (n = 6) showed 100% patency on follow-up angiography. There was a significant difference between the follow-up sizes (mean 1.72 +/- 0.30 mm) of parent arteries and their sizes (mean 1.59 +/- 0.26 mm) before treatment (95% Cl -0.254 to -0.009 mm; p = 0.037, paired-samples t-test).CONCLUSIONS In the current series the deployment of self-expanding closed-cell stents in small arteries was safe and resulted in good patency, especially when the stents were deployed in segments of the parent artery with no acute angles or only 1 acute angle.