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Neuroform 治疗颅内动脉瘤的安全性和有效性:一项前瞻性、连续、法国多中心研究。

Safety and efficacy of neuroform for treatment of intracranial aneurysms: a prospective, consecutive, French multicentric study.

机构信息

CHU Cavale Blanche, Neuroradiology, Brest, France.

出版信息

AJNR Am J Neuroradiol. 2013 Jun-Jul;34(6):1203-8. doi: 10.3174/ajnr.A3379. Epub 2013 Jan 24.

Abstract

BACKGROUND AND PURPOSE

Endovascular embolization of wide-neck intracranial aneurysms can be technically challenging, especially when the anatomy is complex. Stent reconstruction of the parent artery is commonly used to treat wide-neck and bifurcated aneurysms. The main objective of this study was to investigate the periprocedural and midterm morbidity and mortality results of this procedure.

MATERIALS AND METHODS

SENAT is a consecutive, prospective, multicentric study. Patients with unruptured cerebral aneurysms who underwent endovascular treatment with the Neuroform stent system were recruited and recorded. Technical outcomes and complications were also assessed. The midterm anatomic results were re-evaluated at 12-18 months.

RESULTS

A total of 113 stents were used to treat the 107 aneurysms in 107 patients. The mean width of the aneurysm sac was 6.2 mm, and the mean diameter of aneurysm neck was 4.5 mm. The complete occlusion rate postprocedure was 66.4%. The rate of progressive occlusion at 12-18 months was 14%, and the rate of recurrence was 9.7%. The rate of subsequent treatment was 4%. The thromboembolic rate in the periprocedural period was 3.7%, and the rate of delayed TE events was 3%. Overall, the mortality rate at 12-18 months was 1%, and the permanent morbidity rate was 1%.

CONCLUSIONS

Stent-assisted coiling with the Neuroform stent system provides a high level of occlusion with low rates of subsequent treatment despite a predominant population of patients with wide-neck aneurysms. Morbidity and thromboembolic rates were comparable to studies investigating stand-alone coiling.

摘要

背景与目的

颅内宽颈动脉瘤的血管内栓塞治疗具有一定技术难度,尤其是在解剖结构复杂的情况下。支架重建载瘤动脉常用于治疗宽颈和分叉部动脉瘤。本研究的主要目的是评估该技术的围手术期和中期发病率及死亡率。

材料与方法

SENAT 是一项连续的前瞻性多中心研究。招募并记录了使用 Neuroform 支架系统行血管内治疗的未破裂脑动脉瘤患者。还评估了技术结果和并发症。在 12-18 个月时对中期解剖学结果进行了重新评估。

结果

共使用 113 个支架治疗了 107 名患者的 107 个动脉瘤。动脉瘤瘤颈的平均宽度为 6.2mm,平均瘤颈直径为 4.5mm。术后即刻完全闭塞率为 66.4%。12-18 个月时进展性闭塞率为 14%,复发率为 9.7%。随后治疗率为 4%。围手术期血栓栓塞发生率为 3.7%,迟发性血栓栓塞事件发生率为 3%。总的来说,12-18 个月的死亡率为 1%,永久性发病率为 1%。

结论

Neuroform 支架系统辅助弹簧圈栓塞治疗尽管患者以宽颈动脉瘤为主,但仍能达到较高的闭塞率,且后续治疗率较低。发病率和血栓栓塞率与单独使用弹簧圈治疗的研究相当。

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