Flow diversion for aneurysms beyond the circle of Willis: A preliminary experience
Flow diversion for aneurysms beyond the circle of Willis: A preliminary experience
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Willis 环以外动脉瘤的血流改道：初步经验
DOI：
10.1016/j.jocn.2021.11.030
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发表时间：
2021-12-06
影响因子：
2
通讯作者：
Liu, Jianmin
中科院分区：
文献类型：
--
作者：
Li, Sisi;Lu, Zhiwen;Liu, Jianmin
目的：探讨Willis环以外动脉瘤血流导向治疗的安全性和有效性。方法和材料：我们回顾性审查了本中心前瞻性维护的数据库，并入组了Willis环以外（定义为M1、A2和P2节段或其远端）的动脉瘤患者，这些患者接受了FD治疗。结果如下：2017年7月至2020年12月期间，28例患者的28个动脉瘤符合入选标准并被纳入本研究，中位年龄为50岁（IQR，36-63岁）。部署了30个FD，包括5个Pipelines和25个Tubridge FD。2例患者（7.1%）发生围手术期并发症，另有3例患者（10.7%）发生无症状不良事件。迟发性并发症发生率为3.6%（1/28）。所有患者均接受了临床随访，死亡率为0，远期并发症发生率为3.6%（1/28）。26例患者（92.9%）的血管造影随访数据可用，间隔为10 +/- 7个月（范围为2-26个月）。16例患者（61.5%）显示动脉瘤完全或几乎完全闭塞（OKM分级量表D和C）; 6例（23.1%）显示动脉瘤不完全闭塞（OKM分级量表B），4例（15.4%）保持不变（OKM分级量表A）。动脉瘤衍生的穿支的存在与较低的闭塞率相关（p = 0.032）。结论：血流导向技术治疗远端动脉瘤疗效可靠，技术成功率高，永久致残率低。动脉瘤侧支的存在与较低的动脉瘤闭塞率相关。(c)2021爱思唯尔有限公司保留所有权利。
Objective: To evaluate the safety and efficacy of flow diversion (FDs) for the aneurysms beyond the circle of Willis. Methods and materials: We retrospectively reviewed the prospectively maintained database in our center and enrolled patients with aneurysms beyond the circle of Willis (defined as at or distal to the M1, A2, and P2 segments) that were treated with FDs. Results: Between July 2017 to December 2020, 28 patients with 28 aneurysms met the inclusion criteria and were included in this study, with a median age of 50 years old (IQR, 36-63 years). Thirty FDs, including 5 Pipelines and 25 Tubridge FDs, were deployed. Perioperative complications were noticed in 2 patients (7.1%), while asymptomatic adverse events occurred in another three patients (10.7%). Delayed complications occurred in 3.6% of patients (1/28). All patients received clinical follow-up, with the mortality and long-term morbidity of 0 and 3.6% (1/28), respectively. Angiographic follow-up data were available for 26 patients (92.9%) with an interval of 10 +/- 7 months (ranged 2-26 months). Sixteen patients (61.5%) showed complete or nearly complete occlusion of aneurysms (OKM grading scale D and C); 6 cases (23.1%) were revealed incomplete occlusion (OKM grading scale B), and 4 cases (15.4%) remained unchanged (OKM grading scale A). The existence of the perforators derived from aneurysms was associated with a lower occlusion rate (p = 0.032). Conclusion: Flow diversion is reliable in the treatment of distal aneurysms with a high technical success rate and low permanent disability rate. The presence of side branches derived from aneurysms was associated with a lower aneurysm occlusion rate. (c) 2021 Elsevier Ltd. All rights reserved.