Radiology department, University Hospital St. Ivan Rilski, Sofia, Bulgaria.
Department of Interventional Neuroradiology, The Royal London Hospital, London, UK.
Clin Neuroradiol. 2020 Sep;30(3):471-480. doi: 10.1007/s00062-019-00823-y. Epub 2019 Aug 9.
The p64 is a flow modulation device designed to be used in endovascular treatment of intracranial aneurysms. There is limited data on the long-term effectiveness of the device. This study sought to determine the safety and long-term efficacy of this device.
A retrospective review of a prospectively maintained database was performed to identify all patients treated with a p64 between March 2015 and November 2018 at University Hospital St. Ivan Rilski. Anatomical features, intraprocedural complications, clinical, and angiographic outcomes were also taken into account and reviewed.
A total of 72 patients with 72 aneurysms who met the inclusion criteria were identified. Device placement was successful in all patients. Follow-up angiographic imaging at 6 months showed complete occlusion (O'Kelly-Marotta scale [OKM] D) in 55 (76.3%) patients, subtotal aneurysmal filling (OKM B) in 10 (13.8%) patients, and neck remnant (OKM C) in 7 (9.7%) patients. Catheter angiography at 12 months was available for 70 patients (97.2%) and of these patients 91.4% of the aneurysms were completely occluded (OKM D) (64/72). Delayed angiography at 24 months was available for 68 patients (94.4%) and of these 98.5% (67/68) had completely occluded aneurysms. A 36-month angiography was available for 61 patients (84.4%) by which point all aneurysms had been completely occluded (100%). Permanent morbidity due to delayed aneurysmal rupture occurred in one patient (1.38%). The mortality rate was 0%. Self-limiting mild intimal hyperplasia was seen in 2 patients (2.72%).
Treatment of intracranial aneurysms with a p64 flow modulation device is safe and effective with a high success rate and only infrequent complications.
p64 是一种血流调节装置,设计用于颅内动脉瘤的血管内治疗。该装置的长期有效性数据有限。本研究旨在确定该装置的安全性和长期疗效。
对 2015 年 3 月至 2018 年 11 月在圣伊万·里尔斯基大学医院接受 p64 治疗的所有患者进行前瞻性维护数据库的回顾性分析。还考虑并评估了解剖特征、术中并发症、临床和血管造影结果。
共纳入符合纳入标准的 72 例 72 个动脉瘤患者。所有患者均成功放置了设备。6 个月时的随访血管造影显示,55 例(76.3%)完全闭塞(O'Kelly-Marotta 分级[OKM]D),10 例(13.8%)部分填充(OKM B),7 例(9.7%)残留瘤颈(OKM C)。70 例(97.2%)患者可获得 12 个月的导管血管造影,其中 91.4%(64/72)的动脉瘤完全闭塞(OKM D)。68 例(94.4%)患者可获得 24 个月的延迟血管造影,其中 98.5%(67/68)的动脉瘤完全闭塞。61 例(84.4%)患者可获得 36 个月的血管造影,此时所有动脉瘤均完全闭塞(100%)。1 例(1.38%)患者因迟发性动脉瘤破裂发生永久性轻微内膜增生。死亡率为 0%。2 例(2.72%)患者出现自限性轻度内膜增生。
p64 血流调节装置治疗颅内动脉瘤安全有效,成功率高,并发症罕见。