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颅内动脉瘤的WEB治疗:法国观察站中使用WEB DL和WEB SL/SLS的可行性、并发症及1个月安全性结果

WEB Treatment of Intracranial Aneurysms: Feasibility, Complications, and 1-Month Safety Results with the WEB DL and WEB SL/SLS in the French Observatory.

作者信息

Pierot L, Moret J, Turjman F, Herbreteau D, Raoult H, Barreau X, Velasco S, Desal H, Januel A-C, Courtheoux P, Gauvrit J-Y, Cognard C, Soize S, Molyneux A, Spelle L

机构信息

From the Department of Neuroradiology (L.P., S.S.), Hôpital Maison-Blanche, Université Reims-Champagne-Ardenne, Reims, France

Department of Neuroradiology (J.M., L.S.), Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Clichy, France.

出版信息

AJNR Am J Neuroradiol. 2015 May;36(5):922-7. doi: 10.3174/ajnr.A4230. Epub 2015 Feb 5.

Abstract

BACKGROUND AND PURPOSE

Safety analyses in the French Observatory have shown that treatment of intracranial aneurysms by using flow disruption with the Woven EndoBridge Device (WEB) is safe, with low morbidity and no mortality. The objective of this study was to analyze treatment feasibility, complications, and safety results in patients treated with the Woven EndoBridge Device Dual-Layer (WEB DL) and Woven EndoBridge Device Single-Layer/Single-Layer Sphere (WEB SL/SLS) in the French Observatory.

MATERIALS AND METHODS

Patients with bifurcation aneurysms were included in this prospective, multicenter good clinical practices study. A medical monitor independently analyzed procedural and clinical data. The study started with the WEB DL, and secondarily, the WEB SL/SLS was authorized in the study.

RESULTS

Between November 2012 and January 2014, 10 French centers included 62 patients with 63 aneurysms. Thirty patients with 31 aneurysms were treated with the WEB DL, and 32 patients with 32 aneurysms, with the WEB SL/SLS. The percentage of anterior communicating artery aneurysms treated with WEB SL/SLS was significantly higher (37.5%) compared with WEB DL (12.9%) (P = .04). The WEB SL/SLS was more frequently used in aneurysms of <10 mm than the WEB DL (respectively, 96.9% and 67.7%; P = .002). Morbidity was similar in both groups (WEB DL, 3.3%; WEB SL/SLS, 3.1%), and mortality was 0.0% in both groups.

CONCLUSIONS

This comparative study shows increased use of WEB treatment in ruptured, small, and anterior communicating artery aneurysms when using WEB SL/SLS. There was a trend toward fewer thromboembolic complications with the WEB SL/SLS. With both the WEB DL and WEB SL/SLS, the treatment was safe, with low morbidity and no mortality.

摘要

背景与目的

法国观察站的安全性分析表明,使用编织型血管内桥接装置(WEB)进行血流阻断治疗颅内动脉瘤是安全的,发病率低且无死亡率。本研究的目的是分析在法国观察站中使用双层编织型血管内桥接装置(WEB DL)和单层/单层球囊编织型血管内桥接装置(WEB SL/SLS)治疗患者的治疗可行性、并发症及安全性结果。

材料与方法

将分叉动脉瘤患者纳入这项前瞻性、多中心的良好临床实践研究。一名医学监测员独立分析手术和临床数据。研究从WEB DL开始,其次,WEB SL/SLS在研究中获得批准。

结果

在2012年11月至2014年1月期间,法国的10个中心纳入了62例患者的63个动脉瘤。30例患者的31个动脉瘤接受了WEB DL治疗,32例患者的32个动脉瘤接受了WEB SL/SLS治疗。与WEB DL(12.9%)相比,接受WEB SL/SLS治疗的前交通动脉瘤的比例显著更高(37.5%)(P = 0.04)。与WEB DL相比,WEB SL/SLS在直径<10 mm的动脉瘤中使用更为频繁(分别为96.9%和67.7%;P = 0.002)。两组的发病率相似(WEB DL为3.3%;WEB SL/SLS为3.1%),两组的死亡率均为0.0%。

结论

这项比较研究表明,在使用WEB SL/SLS时,破裂、小型和前交通动脉瘤的WEB治疗使用增加。WEB SL/SLS的血栓栓塞并发症有减少的趋势。使用WEB DL和WEB SL/SLS进行治疗均安全,发病率低且无死亡率。

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