ReXiaTi NiZaMiDingJiang, AiKeReMu ReXiDan, KaDeEr KaHeErMan, Fan Yan-Dong, Feng Zhao-Hai, Wang Kai, SuErTanNiYa TeWuErBaTi, Dou Tao-Tao, Wu Hai-Qiang, AiSha MaiMaiTiLi, Cheng Xiao-Jiang
Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China.
Biomed Mater Eng. 2018;29(2):137-146. doi: 10.3233/BME-171718.
To observe the short-term efficacy of Pipeline embolization divice (PED) for the treatment of complex intracranial aneurysms.
The clinical data of 29 consecutive patients with 32 intracranial aneurysms treated with PED between April 2015 to September 2016 were analyzed retrospectively. There were 3 small aneurysm, 15 large aneurysms, 8 giant aneurysms, 5 fusiform ayneurysms and 1 recidivation. The vessels include 25 anterior circulation and 4 posterior circulation.
We treated 31 aneurysms with 30 PEDs and all of the stents were implanted successfully. 1 case of single aneurysm was multiple divices implanted and 1 case of 3 aneurysms were treated by single PED. 12 of the 29 patients were implanted PED only, 17 were implanted PED with coils, 2 underwent balloon remodeling after the PED implanted. The ostia of 19 ophthalmic arteries, 10 posterior communicating arteries, 4 posterior inferior cerebellar arteries and 1 anterior cerebral artery were covered by PED during procedures; 1 ophthalmic arteries and 1 posterior communicating artery disappeared, no branch vessels occlusion and parent artery stenosis occurred.Hemorrhagic complacations occurred in 2 patients, 2 hours and 5 days after procedure respectively. Radiographic follow-up examnations were carried out in 24 patients and revealed complete occlusion in 21 patients, uncomplete occlusion in 3 patients. No neurological injure occurred in 27 patients who received a clinical follow-up.
PED provide a safe and effective methord for the treatment of intracranial complex aneurysms like wide-neck aneurysms, fusiform aneurysms, giant aneurysms in low risk of procedural complications and high rates of aneurysm occlusion.
观察Pipeline栓塞装置(PED)治疗复杂颅内动脉瘤的短期疗效。
回顾性分析2015年4月至2016年9月期间连续29例应用PED治疗32个颅内动脉瘤的临床资料。其中小动脉瘤3个,大动脉瘤15个,巨大动脉瘤8个,梭形动脉瘤5个,复发动脉瘤1个。血管分布包括前循环25个,后循环4个。
应用30枚PED治疗31个动脉瘤,所有支架均成功植入。1例单个动脉瘤植入多枚装置,1例3个动脉瘤用单枚PED治疗。29例患者中12例仅植入PED,17例植入PED联合弹簧圈,2例在植入PED后行球囊重塑。术中PED覆盖19支眼动脉、10支后交通动脉、4支小脑后下动脉和1支大脑前动脉;1支眼动脉和1支后交通动脉消失,未发生分支血管闭塞及载瘤动脉狭窄。2例患者分别在术后2小时和5天出现出血并发症。24例患者进行影像学随访检查,结果显示21例完全闭塞,3例不完全闭塞。27例接受临床随访的患者未发生神经损伤。
PED为治疗颅内复杂动脉瘤如宽颈动脉瘤、梭形动脉瘤、巨大动脉瘤提供了一种安全有效的方法,手术并发症风险低,动脉瘤闭塞率高。