用于宽颈大脑中动脉动脉瘤血管内治疗的pCONus装置
pCONus Device for the Endovascular Treatment of Wide-Neck Middle Cerebral Artery Aneurysms.
作者信息
Gory B, Aguilar-Pérez M, Pomero E, Turjman F, Weber W, Fischer S, Henkes H, Biondi A
机构信息
From the Department of Interventional Neuroradiology (B.G., F.T.), Neurologic Hospital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
Department of Neuroradiology (M.A.-P., H.H.), Klinikum Stuttgart, Stuttgart, Germany.
出版信息
AJNR Am J Neuroradiol. 2015 Sep;36(9):1735-40. doi: 10.3174/ajnr.A4392. Epub 2015 Jul 23.
BACKGROUND AND PURPOSE
Endovascular treatment of bifurcation middle cerebral artery aneurysms with a wide neck could be challenging, and many lesions are still treated by a surgical approach. The pCONus is a newly emerging device for wide-neck bifurcation intracranial aneurysms. To date, a single report on the treatment of intracranial aneurysms including all locations has been published. We report our experience with pCONus in the treatment of wide-neck MCA aneurysms.
MATERIALS AND METHODS
MCA aneurysms treated with pCONus in 4 European centers were retrospectively reviewed.
RESULTS
Forty MCA aneurysms (mean dome size, 7.7 mm; mean neck size, 5.6 mm) were treated in 40 patients (mean age, 62 years). Aneurysm coiling was performed after deployment of 1 pCONus in 95% (38/40) of cases and after deployment of 2 pCONus devices in 5% (2/40). No procedural angiographic complications were observed. Reversible neurologic complications were noted in 5% (2/40), and permanent neurologic complication, in 2.5% (1/40) at 1 month. There was no mortality. No aneurysms bled or rebled after treatment. Immediate angiographic results were complete aneurysm occlusion in 25% (10/40), neck remnant in 47.5% (19/40), and aneurysm remnant in 27.5% (11/40). Follow-up (mean, 6.8 months) was available for 33 aneurysms (82.5%). Stable or improved results were observed in all except 3 cases, including 48.5% complete occlusions (16/33), 30.3% neck remnants (10/33), and 21.2% aneurysm remnants (7/33). There was no in-stent stenosis or jailed branch occlusion. There was no angiographic recurrence of initially totally occluded aneurysms.
CONCLUSIONS
MCA aneurysms with a wide neck are amenable to treatment with pCONus.
背景与目的
宽颈大脑中动脉分叉部动脉瘤的血管内治疗具有挑战性，许多此类病变仍采用外科手术方法治疗。pCONus是一种用于治疗宽颈颅内分叉部动脉瘤的新型装置。迄今为止，仅发表过一篇关于包括所有部位颅内动脉瘤治疗的报告。我们报告使用pCONus治疗宽颈大脑中动脉动脉瘤的经验。
材料与方法
对4个欧洲中心使用pCONus治疗的大脑中动脉动脉瘤进行回顾性分析。
结果
40例患者的40个大脑中动脉动脉瘤（平均瘤顶大小7.7mm；平均瘤颈大小5.6mm）接受了治疗（平均年龄62岁）。95%（38/40）的病例在植入1个pCONus后进行动脉瘤栓塞，5%（2/40）的病例在植入2个pCONus装置后进行栓塞。未观察到术中血管造影并发症。1个月时，5%（2/40）出现可逆性神经并发症，2.5%（1/40）出现永久性神经并发症。无死亡病例。治疗后无动脉瘤出血或再出血。即刻血管造影结果显示，25%（10/40）动脉瘤完全闭塞，47.5%（19/40）瘤颈残留，27.5%（11/40）动脉瘤残留。33个动脉瘤（82.5%）获得随访（平均6.8个月）。除了3例，所有病例结果稳定或改善，包括48.5%完全闭塞（16/33），30.3%瘤颈残留（10/33），21.2%动脉瘤残留（7/33）。未发现支架内狭窄或分支血管闭塞。最初完全闭塞的动脉瘤未出现血管造影复发。
结论
宽颈大脑中动脉动脉瘤可用pCONus治疗。
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