Aguilar-Salinas Pedro, Brasiliense Leonardo B C, Walter Christina M, Hanel Ricardo A, Dumont Travis M
Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.
Division of Neurosurgery, University of Arizona, Tucson, Arizona, USA.
World Neurosurg. 2018 Jul;115:288-294. doi: 10.1016/j.wneu.2018.04.102. Epub 2018 Apr 24.
The PulseRider is an innovative stent-like device designed for the treatment of intracranial bifurcation aneurysms. The aim of this study was to assess the current evidence on safety and effectiveness of the PulseRider.
A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following databases were searched: PubMed, Ovid MEDLINE, and Scopus. The search strategy consisted of "pulserider," "bifurcation aneurysm," and "endovascular" in both AND and OR combinations. Studies included were original research articles in peer-reviewed journals. The manuscripts were thoroughly examined for study design, outcomes, and results.
Three studies were identified describing use of the PulseRider device in the treatment of 63 patients with 63 bifurcation aneurysms. We identified 2 multicenter case series and 1 single-arm clinical trial. The majority of aneurysms treated were located at the basilar tip (37, 58.7%). All devices were successfully deployed, and there were 5 intraoperative complications (7.9%), including 2 intraoperative aneurysm ruptures, 1 vessel dissection, and 2 thrombus formations. Immediate complete aneurysm occlusion was achieved in 61.9% (39/63) of cases and at the 6-month imaging follow-up, 66.7% (42/63) achieved complete aneurysm occlusion. One recanalization was reported in 1 of the multicenter case series within the 6-month follow-up.
The PulseRider is safe and probably effective for the treatment of intracranial bifurcation aneurysms, sometimes not amenable for stent-assisted coiling. However, current evidence is limited to a small sample and short follow-up. In addition, the device has not been compared with other treatment modalities.
PulseRider是一种创新的支架样装置，设计用于治疗颅内分叉动脉瘤。本研究的目的是评估关于PulseRider安全性和有效性的现有证据。
按照系统评价和Meta分析的首选报告项目指南进行系统评价。检索了以下数据库：PubMed、Ovid MEDLINE和Scopus。检索策略包括“pulserider”、“分叉动脉瘤”和“血管内”的AND和OR组合。纳入的研究为同行评审期刊上的原创研究文章。对手稿进行了全面审查，以了解研究设计、结果和结论。
确定了三项研究，描述了PulseRider装置在治疗63例患者的63个分叉动脉瘤中的应用。我们确定了2个多中心病例系列和1个单臂临床试验。治疗的大多数动脉瘤位于基底动脉尖（37个，58.7%）。所有装置均成功植入，术中并发症有5例（7.9%），包括2例术中动脉瘤破裂、1例血管夹层和2例血栓形成。61.9%（39/63）的病例实现了即刻完全动脉瘤闭塞，在6个月的影像学随访中，66.7%（42/63）实现了完全动脉瘤闭塞。在多中心病例系列之一的6个月随访期内报告了1例再通。
PulseRider在治疗颅内分叉动脉瘤方面是安全的，可能也是有效的，这些动脉瘤有时不适用于支架辅助弹簧圈栓塞术。然而，目前的证据仅限于小样本和短期随访。此外，该装置尚未与其他治疗方式进行比较。
