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采用低轮廓可视化腔内支撑(LVIS)支架治疗的225例颅内动脉瘤:一项单中心回顾性研究。

225 intracranial aneurysms treated with the Low-profile Visualized Intraluminal Support (LVIS) stent: a single-center retrospective study.

作者信息

Su Wei, Zhang Yisen, Chen Junfan, Liu Jian, Rajah Gary, Yang Xinjian

机构信息

a Beijing Neurosurgical Institute, Beijing Tiantan Hospital , Capital Medical University , Beijing , China.

b Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine , Tsinghua University , Beijing , China.

出版信息

Neurol Res. 2018 Jun;40(6):445-451. doi: 10.1080/01616412.2018.1457608. Epub 2018 Apr 23.

Abstract

Background For the treatment of intracranial aneurysms, the low-profile visualized intraluminal support (LVIS) stent is a new generation of highly visible-braided stent that was recently introduced in China. Here, we report our single-center retrospective experience of safety and efficacy utilizing LVIS for stent-assisted coiling of intracranial aneurysms. Methods We included 218 patients with intracranial aneurysms consecutively treated with LVIS SR stents at our center in this study. Postoperative and follow-up embolization scores, procedural complications, clinical and angiographic findings at mid-term follow-up, as well as recurrence rate, preoperative and follow-up mRS scores were analyzed. Results Two hundred and eighteen patients with two hundred and twenty five intracranial aneurysms were enrolled. The locations and distribution were ICA (125, 55.6%), PcomA (47, 20.9%), VA (38, 16.8%), and BA (15, 6.7%). Two hundred and eighteen aneurysms were treated with the stent-assisted coiling and seven patients with LVIS stents alone. Angiographic follow-up was available for 115 (51.1%) aneurysms, 8 (7.0%) of which had recurrences including 7 (6.5%) unruptured aneurysms and 1(14.3%) ruptured aneurysm. The procedural complication rate was 2.75% in total, including distal hemorrhage (1, 0.45%; SAH), ischemic events (5, 2.3%). Conclusions Our single-center retrospective experience is one of the larger studies to date assessing the LVIS device. Compared with many laser-cut stent studies, the LVIS device had a higher aneurysm complete occlusion rate at follow-up coupled with low complication rates. However, this study was our initial experience with LVIS, larger patient numbers, and longer follow-up will be needed to fully assess the long-term efficacy of LVIS in treating intracranial aneurysms.

摘要

背景 对于颅内动脉瘤的治疗,低轮廓可视化腔内支撑(LVIS)支架是新一代高可视性编织支架,最近在中国推出。在此,我们报告我们单中心使用LVIS进行颅内动脉瘤支架辅助弹簧圈栓塞术的安全性和有效性的回顾性经验。方法 本研究纳入了在我们中心连续接受LVIS SR支架治疗的218例颅内动脉瘤患者。分析术后和随访栓塞评分、手术并发症、中期随访时的临床和血管造影结果,以及复发率、术前和随访改良Rankin量表(mRS)评分。结果 纳入218例患者,共225个颅内动脉瘤。其位置和分布为颈内动脉(ICA,125个,55.6%)、后交通动脉(PcomA,47个,20.9%)、椎动脉(VA,38个,16.8%)和基底动脉(BA,15个,6.7%)。218个动脉瘤接受了支架辅助弹簧圈栓塞术,7例患者仅使用了LVIS支架。115个(51.1%)动脉瘤有血管造影随访结果,其中8个(7.0%)复发,包括7个(6.5%)未破裂动脉瘤和1个(14.3%)破裂动脉瘤。手术并发症总发生率为2.75%,包括远端出血(1例,0.45%;蛛网膜下腔出血)、缺血性事件(5例,2.3%)。结论 我们的单中心回顾性经验是迄今为止评估LVIS装置的较大规模研究之一。与许多激光切割支架研究相比,LVIS装置在随访时动脉瘤完全闭塞率更高,并发症发生率更低。然而,本研究是我们对LVIS的初步经验,需要更多患者数量和更长随访时间来全面评估LVIS治疗颅内动脉瘤的长期疗效。

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