Goodman Campbell Brain and Spine, Ascension St. Vincent Medical Center, Division of Interventional Neuroradiology, Indianapolis IN, United States; Department of Interventional Neuroradiology, University of Pittsburgh Medical Center-Hamot, 300 State St, Suite 4100 Erie, 16550 PA, United States.
Westchester Medical Center, Department of Endovascular Neurosurgery and Neurocritical Care, Valhalla, NY, United States.
J Neuroradiol. 2021 Sep;48(5):391-396. doi: 10.1016/j.neurad.2019.06.002. Epub 2019 Jun 20.
Reports on flow diversion treatment of aneurysms beyond the Circle of Willis are limited, with few series dedicated to anterior communicating artery region aneurysms. The purpose of this study is to evaluate the safety and effectiveness of the pipeline embolization device in the treatment of anterior communicating artery region aneurysms.
The neuro-interventional database of a single institution was retrospectively reviewed for anterior communicating artery aneurysms treated with the pipeline embolization device between November 2016 and December 2018. Data on clinical presentation, aneurysm location, type, vessel size, procedural complications, clinical and imaging follow-up were analyzed.
Ten patients with 11 anterior communicating artery aneurysms were included. Procedural success was achieved in 9/10 patients (90%). Flow diversion with the pipeline embolization device yielded occlusion in 100% of patients at 6.5 months. Symptomatic ischemic complications occurred in 2/10 patients (20%); only one of who had permanent symptoms. Hemorrhagic groin complications were encountered in 2/10 patients (20%). There were no deaths and no cerebral hemorrhagic complications.
Flow diversion therapy may provide a feasible solution for anterior communicating artery region aneurysms that are not amenable to traditional surgical or endovascular modalities.
关于 Willis 环以外的动脉瘤的血流导向治疗的报告有限,很少有专门针对前交通动脉区域动脉瘤的系列报道。本研究旨在评估Pipeline 栓塞装置在治疗前交通动脉区域动脉瘤中的安全性和有效性。
回顾性分析了一家单中心的神经介入数据库中,2016 年 11 月至 2018 年 12 月期间使用 Pipeline 栓塞装置治疗的前交通动脉动脉瘤患者的临床资料。分析了临床表现、动脉瘤位置、类型、血管大小、手术并发症、临床和影像学随访等数据。
10 例患者的 11 个前交通动脉动脉瘤被纳入研究。9/10 例患者(90%)达到了手术成功。6.5 个月时,Pipeline 栓塞装置的血流导向治疗使 100%的患者达到了完全闭塞。2/10 例患者(20%)发生了症状性缺血性并发症,其中只有 1 例为永久性症状。2/10 例患者(20%)发生了腹股沟出血并发症。无死亡病例,无脑出血并发症。
血流导向治疗可能为不适合传统手术或血管内治疗的前交通动脉区域动脉瘤提供一种可行的解决方案。