Morais Ricardo, Mine Benjamin, Bruyère Pierre Julien, Naeije Gilles, Lubicz Boris
Cliniques Universitaires de Bruxelles, Erasme University Hospital, Imagerie médicale - Clinique de Neuroradiologie, Route de Lennik 808 - B, Bruxelles, Belgium.
Medical Imaging Department, Coimbra University and Hospital Centre, Coimbra, Portugal.
Neuroradiology. 2017 Mar;59(3):263-269. doi: 10.1007/s00234-017-1786-2. Epub 2017 Feb 24.
INTRODUCTION: The p64 flow diverter (FD) device is a fully resheathable and detachable stent dedicated for endovascular treatment (EVT) of intracranial aneurysms (IAs). We report our mid-term experience with this device. METHODS: Between January 2015 and February 2016, we retrospectively identified, in our prospectively maintained database, all patients treated with p64 FDs in two institutions. Independent clinical follow-up was performed by a vascular neurologist. Imaging follow-up included a digitalized subtraction angiography (DSA) at 3, 6, and 12 months and a magnetic resonance angiography (MRA) at 12 months. RESULTS: Thirty-nine patients (22 women/17 men; median age 54 years) with 48 IAs (median aneurysm size 6.2 mm; mean neck size 3.4 mm) were identified. All IAs were saccular and unruptured. Failure of safe stent delivery occurred in 15% of cases (7/48 IAs) which were excluded. Transient neurological morbidity occurred in 2/35 patients (5.7%) including one delayed thromboembolic complication. No permanent morbidity or mortality was encountered. Complete aneurysmal occlusion at 3, 6, and 12 months was 20/30 (66.6%), 18/27 (66.6%), and 24/28 (85.7%), respectively. Intra-stent stenosis was observed in 9/29 patients (31%) and classified as moderate in 4/29 (13.7%) and mild in 5/29 patients (17.2%). These stenoses gradually improved over time, with only mild stenoses being identified at 6 months and at 12 months. CONCLUSION: In our small case series, the p64 FD stent appears safe and effective for EVT of IAs. A high occlusion rate and a low morbidity rate were observed.
引言:p64血流导向装置是一种完全可重新鞘内操作且可分离的支架,专门用于颅内动脉瘤(IA)的血管内治疗(EVT)。我们报告了使用该装置的中期经验。 方法:在2015年1月至2016年2月期间,我们在两个机构中,从前瞻性维护的数据库中回顾性识别了所有接受p64血流导向装置治疗的患者。由血管神经科医生进行独立的临床随访。影像学随访包括在3、6和12个月时进行数字化减影血管造影(DSA),以及在12个月时进行磁共振血管造影(MRA)。 结果:共识别出39例患者(22例女性/17例男性;中位年龄54岁),有48个颅内动脉瘤(中位动脉瘤大小6.2mm;平均瘤颈大小3.4mm)。所有颅内动脉瘤均为囊状且未破裂。15%的病例(7/48个颅内动脉瘤)出现安全支架置入失败,这些病例被排除。2/35例患者(5.7%)出现短暂性神经功能障碍,包括1例延迟性血栓栓塞并发症。未出现永久性神经功能障碍或死亡。在3、6和12个月时,动脉瘤完全闭塞的比例分别为20/30(66.6%)、18/27(66.6%)和24/28(85.7%)。在29例患者中观察到支架内狭窄,其中4/29例(13.7%)为中度狭窄,5/29例(17.2%)为轻度狭窄。这些狭窄随时间逐渐改善,在6个月和12个月时仅发现轻度狭窄。 结论:在我们的小病例系列中,p64血流导向装置对颅内动脉瘤血管内治疗似乎是安全有效的。观察到较高的闭塞率和较低的发病率。
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