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一种用于治疗28例大型或巨大型颅内动脉瘤的新型血流导向装置(Tubridge):单中心经验。

A novel flow-diverting device (Tubridge) for the treatment of 28 large or giant intracranial aneurysms: a single-center experience.

作者信息

Zhou Y, Yang P-F, Fang Y-B, Xu Y, Hong B, Zhao W-Y, Li Q, Zhao R, Huang Q-H, Liu J-M

机构信息

From the Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, P.R. China.

出版信息

AJNR Am J Neuroradiol. 2014 Dec;35(12):2326-33. doi: 10.3174/ajnr.A3925. Epub 2014 Apr 10.

Abstract

BACKGROUND AND PURPOSE

The Tubridge flow diverter is a novel device developed in China and aimed at reconstructing the parent artery and occluding the aneurysm. We conducted this study to evaluate its feasibility, safety, and efficacy for the treatment of large or giant internal carotid artery aneurysms, which are still challenging with conventional therapy.

MATERIALS AND METHODS

The clinical and angiographic data of 28 patients with 28 large or giant internal carotid artery aneurysms treated with Tubridge flow diverters were prospectively collected and analyzed.

RESULTS

Thirty-three Tubridge flow diverters were successfully implanted except for 1 poor midstent opening; the result was a technical success rate of 97.0% (32/33). Follow-up angiographies were available for 25 aneurysms; the mean follow-up was 9.9 months (5-24 months). Of the 25 aneurysms, 18 (72.0%) were completely occluded, 6 (24.0%) were improved, and 1 (4.0%) was unchanged. All of the visible covered branches and parent arteries were patent, with no stenosis or obliteration. During a follow-up of 6-30 months (mean, 19 months), symptoms were resolved in 13 patients, improved in 6 patients, and unchanged in 4 patients. Five patients experienced transient clinical deterioration due to a postoperative increased mass effect. Procedure-related morbidity and mortality were both zero.

CONCLUSIONS

Our preliminary experience shows that the Tubridge flow diverter is a safe and effective tool for treating large and giant internal carotid artery aneurysms. However, multicenter randomized trials and studies involving a long-term follow-up are necessary.

摘要

背景与目的

Tubridge血流导向装置是中国研发的一种新型装置,旨在重建载瘤动脉并闭塞动脉瘤。我们开展本研究以评估其治疗大型或巨大型颈内动脉瘤的可行性、安全性及有效性,传统治疗方法对这些动脉瘤仍具有挑战性。

材料与方法

前瞻性收集并分析28例使用Tubridge血流导向装置治疗的28例大型或巨大型颈内动脉瘤患者的临床及血管造影数据。

结果

除1例支架中段打开不佳外,成功植入33枚Tubridge血流导向装置;技术成功率为97.0%(32/33)。25枚动脉瘤有随访血管造影;平均随访时间为9.9个月(5 - 24个月)。25枚动脉瘤中,18枚(72.0%)完全闭塞,6枚(24.0%)改善,1枚(4.0%)无变化。所有可见的分支血管及载瘤动脉均通畅,无狭窄或闭塞。在6 - 30个月(平均19个月)的随访期间,13例患者症状消失,6例改善,4例无变化。5例患者因术后占位效应增加出现短暂临床恶化。与手术相关的发病率和死亡率均为零。

结论

我们的初步经验表明,Tubridge血流导向装置是治疗大型和巨大型颈内动脉瘤的一种安全有效的工具。然而,多中心随机试验及长期随访研究是必要的。

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