Bilgin Ezel Yaltirik, Onal Baran, Emmez Hakan, Akkan Koray, Ilgit Erhan, Bilgin Erkan, Cindil Emetullah, Borcek Alp Ozgun
Gazi University, School of Medicine, Department of Radiology, Ankara, Turkey.
Turk Neurosurg. 2018;28(4):550-556. doi: 10.5137/1019-5149.JTN.20279-17.2.
We report our experience with flow diverter devices in the treatment of intracranial aneurysms arising from the anterior circulation with mid- and long-term follow-up.
Seventy-eight aneurysms in 61 patients (range 25-81 years, 13 male, 48 female) were treated with flow diverter devices. Forty (51.3%) aneurysms were treated with a pipeline embolization device (PED), 24 (30.8%) aneurysms were treated with a SILK stent, 12 (15.4%) aneurysms were treated with a flow redirection endoluminal device (FRED) and two aneurysms were treated with a P64 Flow Modulation Device (P64). Angiographic follow-up data at six months and one year were recorded and the occlusion degrees of the aneurysms were evaluated according to the scale developed by Kamran et al. RESULTS: At six-month follow-up, the complete occlusion (grade 4) rate was 60.8% and at one-year this rate had increased to 74.3%. Statistical analysis revealed a significant difference (p=0.002) between six-month and one-year follow-up results but there was no significant association (p=0.531, p=1.000) between aneurysm occlusion rate and aneurysm diameter. Two patients (3.2%) died due to hemorrhagic complications.
Endovascular treatment of intracranial anterior circulation aneurysms with flow diverters is a safe and effective treatment option. A high rate of stable occlusion is achieved at long-term follow-up.
我们报告使用血流导向装置治疗前循环颅内动脉瘤的经验,并进行中长期随访。
61例患者(年龄25 - 81岁,男性13例,女性48例)的78个动脉瘤接受了血流导向装置治疗。40个(51.3%)动脉瘤采用管道栓塞装置(PED)治疗,24个(30.8%)动脉瘤采用SILK支架治疗,12个(15.4%)动脉瘤采用血流导向腔内装置(FRED)治疗,2个动脉瘤采用P64血流调节装置(P64)治疗。记录6个月和1年时的血管造影随访数据,并根据Kamran等人制定的量表评估动脉瘤的闭塞程度。结果:在6个月的随访中,完全闭塞(4级)率为60.8%,1年时该率增至74.3%。统计分析显示6个月和1年随访结果之间存在显著差异(p = 0.002),但动脉瘤闭塞率与动脉瘤直径之间无显著关联(p = 0.531,p = 1.000)。2例患者(3.2%)因出血并发症死亡。
采用血流导向装置对颅内前循环动脉瘤进行血管内治疗是一种安全有效的治疗选择。长期随访可实现较高的稳定闭塞率。