Department of Neuroradiology, Saarland University Hospital, Homburg/Saar, Germany.
J Neurointerv Surg. 2019 Feb;11(2):196-199. doi: 10.1136/neurintsurg-2018-013975. Epub 2018 Jul 3.
In recent years, implantation of flow diverters has emerged as an option for the endovascular treatment of intracranial aneurysms. One complication of treatment with flow diverters is the occurrence of in-stent stenosis, which has been reported to be partially reversible. The purpose of our study was to assess the incidence and dynamics of in-stent stenosis on angiographic short term and long term follow-up after treatment with flow diverters.
A retrospective review of our prospectively maintained database identified all patients with intracranial internal carotid artery (ICA) aneurysms treated by flow diverters at our institution between 2014 and 2017. Clinical charts, procedural data, and angiographic results were reviewed.
18 patients were included. The mean short term follow-up was 92±19 days and mean long term follow-up was 449±120 days after treatment. No neurologic complications were observed. There was no procedure related mortality. Long term angiographic results showed complete occlusion in 83.3%, neck remnants in 11.1%, and incomplete occlusion in 5.5% of cases. In-stent stenosis was observed in all cases. Mean stenosis improved significantly from 30% on short term follow-up to 12% on long-term follow-up (P<0.0001).
In-stent stenosis is a common finding on short term follow-up after the treatment with flow diverters but improves over time.
近年来，血流导向装置的植入已成为颅内动脉瘤血管内治疗的一种选择。血流导向装置治疗的一种并发症是支架内狭窄的发生，据报道这种狭窄部分是可逆转的。本研究的目的是评估血流导向装置治疗后短期和长期血管造影随访中支架内狭窄的发生率和动态变化。
对我们机构在 2014 年至 2017 年间使用血流导向装置治疗的颅内颈内动脉（ICA）动脉瘤的所有患者进行了前瞻性数据库的回顾性分析。回顾了临床图表、手术数据和血管造影结果。
共纳入 18 例患者。治疗后平均短期随访时间为 92±19 天，平均长期随访时间为 449±120 天。未观察到神经并发症。无与手术相关的死亡。长期血管造影结果显示完全闭塞 83.3%，残余颈部 11.1%，不完全闭塞 5.5%。所有病例均存在支架内狭窄。支架内狭窄程度从短期随访时的 30%显著改善至长期随访时的 12%（P<0.0001）。
血流导向装置治疗后短期随访时支架内狭窄是常见的发现，但随着时间的推移会有所改善。
