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使用低轮廓可视化腔内支撑支架或血流导向装置对大脑中动脉动脉瘤进行血管内治疗的比较。

Comparison of endovascular treatment for middle cerebral artery aneurysm with a low-profile visualized intraluminal support stent or pipeline embolization device.

作者信息

Lu Peng, Zhang Ye, Niu Huanjiang, Wang Yirong

机构信息

Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, P.R. China.

出版信息

Exp Ther Med. 2019 Sep;18(3):2072-2078. doi: 10.3892/etm.2019.7775. Epub 2019 Jul 16.

DOI:10.3892/etm.2019.7775
PMID:31410163
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6676140/
Abstract

The aim of the present study was to evaluate the safety and effectiveness of low-profile visualized intraluminal support (LVIS) stent and the pipeline embolization device (PED) for middle cerebral artery (MCA) aneurysm treatment. Data of patients with MCA aneurysms who received endovascular treatment with LVIS stent or PED added to the hospital's database between August 2016 and March 2018 were retrospectively collected, and the clinical results and angiographic outcomes were evaluated. A total of 43 patients were included in the study, of whom 23 received LVIS stents and 20 received PED. The rate of complete occlusion was similar in the two groups at 6 months post-treatment (90.9 vs. 88.9%; P=0.832). Peri-operative complications were more frequent in the PED group; however, the LVIS group had more ischemic symptoms during the long-term follow-up. A larger aneurysm size (P=0.032) was associated with recanalization in the two groups. In conclusion, the LVIS stent and PED had acceptable rates of complete occlusion and aneurysm size was an independent predictor for recanalization. LVIS is more effective during the peri-operative period, while PED appears to have higher long-term safety.

摘要

本研究的目的是评估低轮廓可视化腔内支架(LVIS)和管道栓塞装置(PED)治疗大脑中动脉(MCA)动脉瘤的安全性和有效性。回顾性收集了2016年8月至2018年3月期间在医院数据库中接受LVIS支架或PED血管内治疗的MCA动脉瘤患者的数据,并评估了临床结果和血管造影结果。共有43例患者纳入研究,其中23例接受LVIS支架治疗,20例接受PED治疗。两组治疗后6个月的完全闭塞率相似(90.9%对88.9%;P=0.832)。PED组围手术期并发症更常见;然而,LVIS组在长期随访期间缺血症状更多。较大的动脉瘤大小(P=0.032)与两组的再通相关。总之,LVIS支架和PED的完全闭塞率可接受,动脉瘤大小是再通的独立预测因素。LVIS在围手术期更有效,而PED似乎具有更高的长期安全性。

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