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低轮廓可视化腔内支撑装置(LVIS Jr)作为治疗宽颈颅内动脉瘤的新型工具:32例初步经验

Low-profile Visualized Intraluminal Support device (LVIS Jr) as a novel tool in the treatment of wide-necked intracranial aneurysms: initial experience in 32 cases.

作者信息

Behme Daniel, Weber Anushe, Kowoll Annika, Berlis Ansgar, Burke Thomas H, Weber Werner

机构信息

Department of Radiology and Neuroradiology, Klinikum-Vest, Knappschaftskrankenhaus, Recklinghausen, Germany.

Department of Radiology and Neuroradiology, Klinikum Augsburg, Augsburg, Germany.

出版信息

J Neurointerv Surg. 2015 Apr;7(4):281-5. doi: 10.1136/neurintsurg-2014-011157. Epub 2014 Apr 3.

Abstract

BACKGROUND AND PURPOSE

The focus of this study was to determine ease of deployment, safety and effectiveness of the LVIS Jr device.

METHODS

A retrospective analysis was performed of 32 cases comprising 34 aneurysms in which the LVIS Jr device was used for stent-assisted coil embolization of intracranial aneurysms from February to October 2012, including all clinical and angiographic data as well as mid-term follow-up (1-12 months of treatment).

RESULTS

The median age of the patients was 54 years (range 21-76) and 19 (59%) were women. The aneurysms were ruptured in 12/34 cases (35.3%); 26 (76.4%) were located within the anterior circulation and the remaining 8 (23.5%) were located in the posterior circulation. Eleven of the 34 aneurysms (32.3%) were treated with a Y-stent configuration. Immediate total occlusion was observed in 16/34 (47%), near total occlusion (90-95%) in 5/34 (14.7%) and a 'dog ear' or subtotal occlusion in 12/34 (35.2%). A single aneurysm was treated without coil embolization. Complications occurred in 5/34 cases (15%), including two cases of in-stent thrombosis.

CONCLUSIONS

Implantation of the LVIS Jr device as a support device for stent-assisted coil embolization seems to be safe and effective. The LVIS Jr device can also be implanted in a Y-stent configuration, offering a novel technique with a potentially lower risk of thromboembolic complications compared with other devices.

摘要

背景与目的

本研究的重点是确定LVIS Jr装置的部署便利性、安全性和有效性。

方法

对2012年2月至10月期间使用LVIS Jr装置进行颅内动脉瘤支架辅助弹簧圈栓塞的32例患者(共34个动脉瘤)进行回顾性分析,包括所有临床和血管造影数据以及中期随访(治疗后1至12个月)。

结果

患者的中位年龄为54岁(范围21 - 76岁),19例(59%)为女性。34个动脉瘤中12个(35.3%)破裂;26个(76.4%)位于前循环,其余8个(23.5%)位于后循环。34个动脉瘤中有11个(32.3%)采用Y形支架构型治疗。16/34(47%)观察到即刻完全闭塞,5/34(14.7%)接近完全闭塞(90 - 95%),12/34(35.2%)出现“狗耳”或次全闭塞。1个动脉瘤未进行弹簧圈栓塞治疗。5/34例(15%)发生并发症,包括2例支架内血栓形成。

结论

植入LVIS Jr装置作为支架辅助弹簧圈栓塞的支撑装置似乎是安全有效的。LVIS Jr装置也可以采用Y形支架构型植入,与其他装置相比,提供了一种潜在血栓栓塞并发症风险较低的新技术。

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