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采用编织型 EndoBridge 17 装置血管内治疗颅内动脉瘤的双中心经验:包括中期随访结果的回顾性分析。

Two-Center Experience in the Endovascular Treatment of Intracranial Aneurysms Using the Woven EndoBridge 17 Device Including Midterm Follow-Up Results: A Retrospective Analysis.

机构信息

Klinikum Augsburg (C.M., A.B.), Klinik für Diagnostische Radiologie und Neuroradiologie, Ausburg, Germany.

From the Knappschaftskrankenhaus Bochum-Langendreer (I.K., W.W., S.F.), Universitätsklinik, Institut für Diagnostische und Interventionelle Radiologie, Neuroradiologie, Nuklearmedizin, Bochum, Germany.

出版信息

AJNR Am J Neuroradiol. 2019 Sep;40(9):1517-1522. doi: 10.3174/ajnr.A6177.

Abstract

BACKGROUND AND PURPOSE

The Woven EndoBridge device proved its effectiveness in the treatment of ruptured and unruptured intracranial aneurysms as a stand-alone device. Before 2016, Woven EndoBridge deployment required at least a 0.021-inch microcatheter. In 2016, a smaller device, the Woven EndoBridge 17 with finer size increments that used a 0.017-inch microcatheter, was introduced. We retrospectively analyzed our initial and follow-up results with the Woven EndoBridge 17 in ruptured and unruptured aneurysms.

MATERIALS AND METHODS

One hundred twenty-seven intracranial aneurysms in 117 patients were scheduled for treatment with the Woven EndoBridge 17 between June 2017 and February 2019. Twenty-nine aneurysms were ruptured.

RESULTS

Treatment was performed as intended in 124 of 127 cases (97.6%). Additional devices such as stents or coils were used in 12 cases (9.7%). Five thromboembolic complications and 1 hemorrhagic complication were encountered, resulting in clinical deterioration in 2 patients. The overall morbidity and mortality in the entire series have been 1.7% and 0.0% to date, respectively. The follow-up results at 3 and 12 months revealed complete occlusion in 76.1% (70/92) and 78.0% (32/41).

CONCLUSIONS

The Woven EndoBridge 17 device is safe in the treatment of small broad-based aneurysms without the general need for additional devices. The low complication rate and the promising follow-up results underline the value of this technique in a growing range of endovascular treatment options for intracranial aneurysms.

摘要

背景与目的

Woven EndoBridge 装置已被证明可作为一种独立的器械,安全有效地治疗破裂和未破裂的颅内动脉瘤。在 2016 年之前,部署 Woven EndoBridge 需要至少使用 0.021 英寸的微导管。2016 年,推出了一种更小的装置——Woven EndoBridge 17,其尺寸更小,采用 0.017 英寸的微导管,尺寸递增更精细。我们回顾性分析了使用 Woven EndoBridge 17 治疗破裂和未破裂的颅内动脉瘤的初始和随访结果。

材料与方法

2017 年 6 月至 2019 年 2 月,我们计划对 117 例患者的 127 个颅内动脉瘤采用 Woven EndoBridge 17 进行治疗,其中 29 个动脉瘤破裂。

结果

在 127 例患者中,124 例(97.6%)按计划进行了治疗。在 12 例(9.7%)中使用了其他器械,如支架或线圈。发生了 5 例血栓栓塞并发症和 1 例出血性并发症,导致 2 例患者临床恶化。到目前为止,整个系列的总发病率和死亡率分别为 1.7%和 0.0%。3 个月和 12 个月的随访结果显示,完全闭塞率分别为 76.1%(70/92)和 78.0%(32/41)。

结论

Woven EndoBridge 17 装置在治疗小的基底宽的动脉瘤时是安全的,通常不需要额外的器械。低并发症发生率和有希望的随访结果强调了该技术在颅内动脉瘤不断增加的血管内治疗选择中的价值。

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