Flow-Diverter Stents for the Treatment of Saccular Middle Cerebral Artery Bifurcation Aneurysms
Flow-Diverter Stents for the Treatment of Saccular Middle Cerebral Artery Bifurcation Aneurysms
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DOI：
10.3174/ajnr.a4540
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发表时间：
2016-02-01
影响因子：
3.5
通讯作者：
Spelle, L.
中科院分区：
文献类型：
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作者：
Caroff, J.;Neki, H.;Spelle, L.
采用血流导向支架治疗了14例患者的15个囊状、非夹层MCA分叉部动脉瘤，并对其进行了回顾性分析。末次随访时手术相关发病率和死亡率分别为21%和0%。完全闭塞率为62%。作者的结论是，与其他治疗方案相比，血流导向支架似乎不适合治疗囊状MCA分叉动脉瘤。背景和目的：血流导向支架已被证明是一种可行的，安全的，有效的技术，特别是对于大颈动脉虹吸部动脉瘤的治疗。在某些情况下，宽颈分叉部动脉瘤仍然是神经介入医生的一个挑战。我们报告的结果，囊性大脑中动脉分叉部动脉瘤与血流导向治疗在我们institution.MATERIALS和METHODS：从该机构的数据库，所有囊性，非夹层大脑中动脉分叉部动脉瘤，治疗与血流导向支架，进行了回顾性审查。技术问题，立即治疗后和后续的血管造影结果，和临床outcomes进行了assessed.Results：14例患者的15个动脉瘤被纳入本研究。经MR成像证实，6例患者（43%）发生了缺血性并发症。末次随访时手术相关发病率和死亡率分别为21%和0%。对13个动脉瘤进行了血管造影随访，平均随访16个月。8个动脉瘤（62%）获得完全闭塞。结论：与其他可用的治疗选择相比，血流导向支架似乎不是治疗囊状MCA分叉部动脉瘤的合适解决方案。
Fourteen patients with 15 saccular, nondissecting MCA bifurcation aneurysms were treated with flow-diverter stents and were retrospectively analyzed. Procedure-related morbidity and mortality at last follow-up were 21% and 0%, respectively. Complete occlusion was achieved in 62%. The authors conclude that compared with other therapeutic options, flow-diverter stents do not appear to be suitable for the treatment of saccular MCA bifurcation aneurysms.BACKGROUND AND PURPOSE: The flow-diverter stent has been proved a feasible, safe, and efficient technique, particularly for the treatment of large and broad-neck carotid siphon aneurysms. Wide-neck bifurcation aneurysms remain, in some cases, a challenge for neurointerventionalists. We report the outcomes of the treatment of saccular middle cerebral artery bifurcation aneurysms with flow diversion in our institution.MATERIALS AND METHODS: From the institution data base, all saccular, nondissecting MCA bifurcation aneurysms, treated with flow-diverter stents, were retrospectively reviewed. Technical issues, immediate posttreatment and follow-up angiographic findings, and clinical outcomes were assessed.RESULTS: Fourteen patients with 15 aneurysms were included in the study. Ischemic complications, as confirmed by MR imaging, occurred in 6 patients (43%). Procedure-related morbidity and mortality at last follow-up were 21% and 0%, respectively. Angiographic follow-up was available for 13 aneurysms, with a mean follow-up of 16 months. Complete occlusion was obtained for 8 aneurysms (62%).CONCLUSIONS: Compared with other available therapeutic options, the flow-diverter stent does not appear to be a suitable solution for the treatment of saccular MCA bifurcation aneurysms.