Department of Neurosurgery, Radboud University Nijmegen Medical Center, Huispost 636, Nijmegen, The Netherlands.
Stroke. 2013 Jun;44(6):1567-77. doi: 10.1161/STROKEAHA.111.000434. Epub 2013 May 16.
In patients harboring intracranial aneurysms, the major goal in treatment is to prevent bleeding. A new generation of an endoluminal device (Surpass Flow Diverter [Surpass]) was developed to reconstruct parent artery and occlude the aneurysm. We present our clinical and angiographic single-center experience.
Patients with a wide range of complex unruptured aneurysms were treated with the Surpass placed in the parent artery and bridging the aneurysm. Clinical and angiographic follow-up were performed at 6 months. Data were prospectively collected.
Thirty seven patients (mean age, 56 years; range, 32-79), harboring 49 unruptured aneurysms were treated at our center. All except 1 patient were treated with a single device. Successful delivery of the device was achieved in all patients. All 35 nonbifurcation aneurysm necks were covered completely, whereas 14 bifurcation aneurysms were only partially covered. There was no major periprocedural morbidity or mortality. During follow-up, 4 patients (10.4%) experienced transient neurological deficit. One patient (3%) developed a minor stroke at 4-month follow-up with persistent neurological deficit. Twelve patients had neurological symptoms related to their aneurysm and 7 showed improvement of these symptoms during follow-up. At 6-month follow-up, 29 of 31 aneurysms studied that had complete neck coverage showed a complete occlusion (94%) including 1 case with a 95% to 100% occlusion, whereas 5 of the 10 bifurcation aneurysms were occluded.
Our study shows high safety and efficacy profile of a new generation endoluminal device in treatment of complex intracranial aneurysms. Long-term studies of treated bifurcation aneurysms are needed.
在颅内动脉瘤患者中,治疗的主要目标是预防出血。一种新一代的腔内装置(Surpass 血流导向装置[Surpass])被开发出来,用于重建母动脉并闭塞动脉瘤。我们报告我们的单中心临床和血管造影经验。
我们用 Surpass 治疗了一系列复杂的未破裂的动脉瘤,将其放置在母动脉中并跨越动脉瘤。在 6 个月时进行临床和血管造影随访。数据是前瞻性收集的。
我们中心治疗了 37 例(平均年龄 56 岁;范围 32-79 岁)、49 个未破裂的动脉瘤患者。除 1 例患者外,所有患者均使用单个装置治疗。所有患者均成功输送了装置。所有 35 个非分叉动脉瘤颈部均完全覆盖,而 14 个分叉动脉瘤仅部分覆盖。无主要围手术期发病率或死亡率。随访期间,4 例患者(10.4%)出现短暂性神经功能缺损。1 例患者(3%)在 4 个月随访时发生轻微中风,持续存在神经功能缺损。12 例患者有与动脉瘤相关的神经症状,7 例患者在随访期间这些症状有所改善。在 6 个月的随访中,31 个研究的动脉瘤中有 29 个完全覆盖颈部显示完全闭塞(94%),包括 1 例 95%至 100%闭塞,而 10 个分叉动脉瘤中有 5 个闭塞。
我们的研究表明,新一代腔内装置治疗复杂颅内动脉瘤具有较高的安全性和疗效。需要对治疗后的分叉动脉瘤进行长期研究。