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加拿大LVIS Jr治疗颅内动脉瘤注册研究(CaRLA)。

Canadian Registry of LVIS Jr for Treatment of Intracranial Aneurysms (CaRLA).

作者信息

Shankar Jai Jai Shiva, Quateen Aiman, Weill Alain, Tampieri Donatella, Del Pilar Cortes Maria, Fahed Robert, Patro Satya, Kaderali Zul, Lum Cheemun, Lesiuk Howard, Ahmed Uzair, Peeling Lissa, Kelly Michael E, Iancu Daniela

机构信息

Department of Diagnostic Imaging, QE II Health Sciences Centre, Halifax, Nova Scotia, Canada.

Division of Neuroradiology, Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Canada.

出版信息

J Neurointerv Surg. 2017 Sep;9(9):849-853. doi: 10.1136/neurintsurg-2016-012611. Epub 2016 Aug 19.

Abstract

INTRODUCTION

Stents reduce the rate of angiographic recurrence of intracranial aneurysms. The newest stent for intracranial use is the Low-profile Visible Intraluminal Support device (LVIS Jr).

OBJECTIVE

To assess the efficacy of the new stent in a multicenter retrospective registry.

MATERIALS AND METHOD

Centers across Canada using LVIS Jr were contacted and asked to participate in a retrospective registry of consecutive patients treated with LVIS Jr for intracranial aneurysms between January 2013 and July 2015.

RESULTS

A total of 102 patients, with saccular aneurysms in 100 patients (72 women; age range 21-78 years; mean 56.0 years; median 57.5 years) were treated with a LVIS Jr stent. The mean maximum diameter of the dome and neck of the aneurysm and dome to neck ratios were 8.3 mm±7.7 mm, 4.4 mm±1.9 mm, and 1.86±1.22, respectively. Angiographic complications arose in 23 patients, clinical complications in 9 patients, and only 3% of permanent neurological deficits occurred. Death occurred in 1 patient, unrelated to the stent. The ruptured status of the aneurysms (OR=3.29; p=0.046) and use of LVIS Jr for bailout (OR=2.54; p=0.053) showed a trend towards significant association with higher angiographic complications. At the last available follow-up, 68 class I, 20 class II, and 12 class III results were seen.

CONCLUSIONS

The LVIS Jr stent is a safe and effective device for stent-assisted coiling, with 3% permanent neurological complications. Stent-assisted coiling continues to be technically challenging in cases of ruptured aneurysms and bailout situations.

摘要

引言

支架可降低颅内动脉瘤血管造影复发率。颅内使用的最新支架是低轮廓腔内可视支撑装置(LVIS Jr)。

目的

在多中心回顾性登记研究中评估这种新型支架的疗效。

材料与方法

联系了加拿大各地使用LVIS Jr的中心,邀请其参与一项回顾性登记研究,该研究纳入2013年1月至2015年7月期间连续使用LVIS Jr治疗颅内动脉瘤的患者。

结果

共有102例患者接受了LVIS Jr支架治疗,其中100例患者为囊状动脉瘤(72例女性;年龄范围21 - 78岁;平均56.0岁;中位数57.5岁)。动脉瘤瘤顶和瘤颈的平均最大直径以及瘤顶与瘤颈比值分别为8.3 mm±7.7 mm、4.4 mm±1.9 mm和1.86±1.22。23例患者出现血管造影并发症,9例患者出现临床并发症,永久性神经功能缺损仅占3%。1例患者死亡,与支架无关。动脉瘤的破裂状态(OR = 3.29;p = 0.046)以及使用LVIS Jr进行补救(OR = 2.54;p = 0.053)显示出与更高的血管造影并发症显著相关的趋势。在最后一次可获得的随访中,观察到68例I级、20例II级和12例III级结果。

结论

LVIS Jr支架是一种用于支架辅助弹簧圈栓塞的安全有效装置,永久性神经并发症发生率为3%。在破裂动脉瘤和补救情况下,支架辅助弹簧圈栓塞在技术上仍然具有挑战性。

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