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新型 Silk Vista Baby 血流导向装置治疗颅内动脉瘤的围手术期安全性和技术结果:多中心经验。

Periprocedural safety and technical outcomes of the new Silk Vista Baby flow diverter for the treatment of intracranial aneurysms: results from a multicenter experience.

机构信息

Endovascular Neurosurgery/Interventional Neuroradiology, Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain.

Neuroradiology and Endovascular Therapy, Besançon University Hospital, Besancon, France.

出版信息

J Neurointerv Surg. 2019 Jul;11(7):723-727. doi: 10.1136/neurintsurg-2019-014770. Epub 2019 Mar 9.

Abstract

PURPOSE

The aim of our study was to assess the technical success and the safety of this new low-profile flow diverter Silk Vista Baby (SVB) by evaluating the intraprocedural and periprocedural complication rate.

MATERIAL/METHODS: Clinical, procedural, and angiographic data were analyzed.

RESULTS

41 consecutive patients (28 women; age average 50.5 years) with 43 aneurysms were treated with SVB. Aneurysm sizes were classified by their maximum diameter, with an average size of 9.5 mm (range 2-30 mm). Thirty-four cases were unruptured. five aneurysms previously ruptured, had recurrence after the initial coiling. There were two ruptured cases. Aneurysms' locations were: M1 segment (five cases), M2 segment (three cases), M3 segment (one case), middle cerebral artery (MCA) bifurcation (six cases), carotid-T (two cases), anterior communicating artery/A1/A2 (11 cases), pericallosal artery (four cases), supraclinoid ICA (two cases), PCom (one case), V4 segment (three cases), PCA (three cases), SCA (one case), and PICA (one case). We had five intraprocedural complications which resolved without clinical consequences and three events postprocedural events. Initial occlusion rates were: eight aneurysms (18.6%) were completely occluded, five aneurysms (11.6%) showed near-complete occlusion, four cases (9.3%) showed incomplete filling, and 26 cases (60.4%) showed persisting filling. The mRS score at discharge from the hospital did not change from the admission mRS score.

CONCLUSION

Our study demonstrated that the use of the new low-profile flow diverter, SVB device, for the treatment of intracranial aneurysms is feasible and technically safe.

摘要

目的

我们的研究旨在通过评估术中及围手术期并发症发生率来评估新型低剖面血流导向装置 Silk Vista Baby(SVB)的技术成功率和安全性。

材料/方法:分析临床、手术过程和血管造影数据。

结果

41 例连续患者(28 例女性;平均年龄 50.5 岁)共 43 个动脉瘤接受 SVB 治疗。根据最大直径对动脉瘤进行分类,平均大小为 9.5mm(范围 2-30mm)。34 例为未破裂动脉瘤,5 例为先前破裂的动脉瘤,在初次线圈栓塞后复发,还有 2 例破裂动脉瘤。动脉瘤位置:M1 段(5 例)、M2 段(3 例)、M3 段(1 例)、大脑中动脉(MCA)分叉(6 例)、颈内-交通支(2 例)、前交通动脉/大脑前动脉 A1 段/大脑中动脉 A2 段(11 例)、胼周动脉(4 例)、前循环颈内动脉(2 例)、后交通动脉(PCom,1 例)、V4 段(3 例)、PCA(3 例)、SCA(1 例)和 PICA(1 例)。我们有 5 例术中并发症,没有临床后果,3 例术后出现并发症。初始闭塞率:8 个动脉瘤(18.6%)完全闭塞,5 个动脉瘤(11.6%)显示近完全闭塞,4 个动脉瘤(9.3%)显示不完全填充,26 个动脉瘤(60.4%)显示持续填充。出院时 mRS 评分与入院时 mRS 评分无变化。

结论

我们的研究表明,新型低剖面血流导向装置 SVB 治疗颅内动脉瘤是可行的,技术上是安全的。

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