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Pipeline Flex 栓塞装置联合 Shield 技术治疗未破裂颅内动脉瘤的围手术期结果和早期安全性:一项前瞻性临床研究的初步结果。

Periprocedural outcomes and early safety with the use of the Pipeline Flex Embolization Device with Shield Technology for unruptured intracranial aneurysms: preliminary results from a prospective clinical study.

机构信息

Department of Interventional Neuroradiology/Endovascular Neurosurgery, Fundación Jiménez-Díaz, Madrid, Spain.

Queen Elizabeth Hospital Birmingham, Edgbaston, UK.

出版信息

J Neurointerv Surg. 2017 Aug;9(8):772-776. doi: 10.1136/neurintsurg-2016-012896. Epub 2017 Feb 20.

Abstract

BACKGROUND AND PURPOSE

The Pipeline Embolization Device (PED) has become a routine first-line option for treatment of intracranial aneurysms (IAs). We assessed the early safety and technical success of a new version of PED, Pipeline Flex Embolization Device with Shield Technology (Pipeline Shield), which has the same design and configuration but has been modified to include a surface synthetic biocompatible polymer.

MATERIALS AND METHODS

The Pipeline Flex Embolization Device with Shield Technology (PFLEX) study is a prospective, single-arm, multicenter study for the treatment of unruptured IAs using Pipeline Shield. The primary study endpoints included the occurrence of major stroke in the territory supplied by the treated artery or neurologic death at 1 year post-procedure. Secondary endpoints included the rate of Pipeline Shield-related or procedure-related serious or non-serious adverse events. Analyses were conducted to evaluate early safety findings in the 30-day post-procedure period as well as technical procedural success outcomes.

RESULTS

Fifty patients with 50 unruptured target IAs were enrolled. Mean aneurysm diameter was 8.82±6.15 mm. Thirty-eight aneurysms (76%) were small (<10 mm). Device deployment was technically successful with 98% of devices. Complete wall apposition was achieved immediately post-procedure in 48 cases (96%). No major strokes or neurologic deaths were reported in the 30-day post-procedure period.

CONCLUSIONS

The results of this first experience with the new Pipeline Flex corroborate the early safety of the device. Mid-term and long-term follow-up examinations will provide data on safety outcomes at the 6-month and 1-year follow-up periods.

CLINICAL TRIAL REGISTRATION

NCT02390037.

摘要

背景与目的

Pipeline 栓塞装置(PED)已成为治疗颅内动脉瘤(IA)的常规一线选择。我们评估了一种新型 Pipeline Flex 栓塞装置带有 Shield 技术(Pipeline Shield)的早期安全性和技术成功,该装置具有相同的设计和配置,但经过修改,包括表面合成生物相容性聚合物。

材料与方法

Pipeline Flex 栓塞装置带有 Shield 技术(PFLEX)研究是一项前瞻性、单臂、多中心研究,用于使用 Pipeline Shield 治疗未破裂的 IA。主要研究终点包括治疗动脉供血区的主要卒中或 1 年后的神经死亡。次要终点包括 Pipeline Shield 相关或手术相关的严重或非严重不良事件的发生率。分析评估了 30 天术后期间的早期安全性发现以及技术程序成功结果。

结果

50 名患者(50 个未破裂的目标 IA)入组。平均动脉瘤直径为 8.82±6.15mm。38 个动脉瘤(76%)较小(<10mm)。98%的装置实现了技术上成功的装置部署。48 例(96%)在术后即刻实现完全贴壁。在 30 天术后期间,没有报告主要卒中或神经死亡。

结论

这是新型 Pipeline Flex 的首次经验,结果证实了该装置的早期安全性。中期和长期随访检查将提供 6 个月和 1 年随访期间安全性结果的数据。

临床试验注册号

NCT02390037。

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