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新型颅内动脉瘤闭塞装置的 Contour 早期人体体验

The Contour-Early Human Experience of a Novel Aneurysm Occlusion Device.

机构信息

Department of Interventional Neuroradiology, The Royal London Hospital, Whitechapel Road, E1 1BB, London, UK.

Neuroradiological clinic, Clinica Sagrada Familia, ENERI, Buenos Aires, Argentina.

出版信息

Clin Neuroradiol. 2021 Mar;31(1):147-154. doi: 10.1007/s00062-020-00876-4. Epub 2020 Jan 28.

Abstract

BACKGROUND AND PURPOSE

Endosaccular flow disruption is a recognized treatment options for treating both unruptured and ruptured aneurysms. The Contour device is designed to target the neck of an aneurysm and cause flow disruption within the aneurysm hence promoting thrombosis and neo-endothelialization at the neck. This article presents initial experiences with the Contour.

METHODS

The prospectively maintained database was retrospectively reviewed to identify patients treated with the Contour device. Demographic data, aneurysm characteristics, clinical result, and clinical and radiological follow-up information were recorded.

RESULTS

The review identified 3 patients (2 female), with 3 unruptured aneurysms, of average age 67 ± 8.7 years (range 62-77 years). The aneurysms were all located in the anterior circulation including one pericallosal, one at the A1-2 junction and one on the ICA bifurcation. The mean average dome height was 7.6 ± 0.62 mm (range 7.1-8.3 mm), dome width 5.7 ± 2 mm (range 3.5-7.5 mm), and neck width 3.6 ± 0.95 mm (range 2.5-4.2 mm). At follow-up angiography two of the aneurysms were completely occluded and one device had displaced into the aneurysm sac due to inappropriate positioning of the device. Of the patients one had minor stroke during the postoperative period but returned to baseline neurology. All patients were mRS 0 at last follow-up.

CONCLUSION

The Contour is a promising new aneurysm occlusion device. Further studies with longer term follow-up are required to determine the efficacy of this novel device.

摘要

背景与目的

腔内血流阻断是治疗未破裂和破裂动脉瘤的一种公认的治疗选择。Contour 装置旨在针对动脉瘤颈部,导致动脉瘤内的血流中断,从而促进颈部的血栓形成和新内皮化。本文介绍了 Contour 的初步经验。

方法

回顾性地分析了前瞻性维护的数据库,以确定使用 Contour 装置治疗的患者。记录了人口统计学数据、动脉瘤特征、临床结果以及临床和放射学随访信息。

结果

该回顾性研究共纳入 3 名女性患者,3 例未破裂动脉瘤,平均年龄 67±8.7 岁(62-77 岁)。动脉瘤均位于前循环,包括 1 例胼胝体旁、1 例 A1-2 交界处和 1 例颈内动脉分叉处。平均瘤顶高度为 7.6±0.62mm(7.1-8.3mm),瘤颈宽度为 5.7±2mm(3.5-7.5mm),瘤颈宽度为 3.6±0.95mm(2.5-4.2mm)。在随访血管造影中,2 例动脉瘤完全闭塞,1 例因装置定位不当而移位至动脉瘤囊内。在患者中,1 例在术后期间发生小中风,但恢复到基线神经功能。所有患者在最后一次随访时 mRS 均为 0。

结论

Contour 是一种很有前途的新型动脉瘤闭塞装置。需要进一步的长期随访研究来确定这种新型装置的疗效。

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