Liang Feng, Yang Yibing, Luo Lijuan, Liao Bingye, Zhang Guofeng, Ou Siqi, Xiao Weiping, Guo Ning, Qi Tiewei
Department of Neurosurgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Operation Theater, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Interv Neuroradiol. 2020 Oct;26(5):539-546. doi: 10.1177/1591019920946216. Epub 2020 Jul 28.
The safety and efficacy of the TuBridge flow diverter in treating middle cerebral artery aneurysms remains unknown. In this study, we report our preliminary experience treating complex middle cerebral artery aneurysms using the TuBridge flow diverter.
A prospectively maintained database of intracranial aneurysms treated with the TuBridge flow diverter was retrospectively reviewed, and patients with middle cerebral artery aneurysms were included in this study. Demographics, aneurysm features, complications, and clinical and angiographic outcomes were assessed. Evaluation of the angiographic results included occlusion grade of aneurysm (O'Kelly-Marotta grading scale), patency of jailed branch(es), and in-stent stenosis.
Eight patients with eight middle cerebral artery aneurysms were included in this study. The mean aneurysm size was 11.8 ± 6.8 mm. There were no procedure-related complications and there was no morbidity or mortality at a mean follow-up of 11.3 ± 3.6 months. All patients had follow-up angiograms at a mean of 7.5 ± 4.0 months after surgery. Of the eight patients, there was 1 (12.5%) O'Kelly-Marotta grading scale A, 3 (37.5%) O'Kelly-Marotta grading scale B, 1 (12.5%) O'Kelly-Marotta grading scale C, and 3 (37.5%) O'Kelly-Marotta grading scale D. Of the seven patients with jailed branch, the blood flow of jailed branch was unchanged in 4 (57.1%), decreased in 2 (28.6%), and occluded in 1 (14.3%). In-stent stenosis was mild in 2 (25%) patients and moderate in 1 (12.5%) patient.
Midterm results suggest that endovascular treatment of middle cerebral artery aneurysms using the TuBridge flow diverter is safe and associated with good outcomes. The TuBridge flow diverter may be an option for complex middle cerebral artery aneurysms that are difficult to treat with either clipping or coiling.
TuBridge血流导向装置治疗大脑中动脉动脉瘤的安全性和有效性尚不清楚。在本研究中，我们报告了使用TuBridge血流导向装置治疗复杂大脑中动脉动脉瘤的初步经验。
回顾性分析前瞻性维护的使用TuBridge血流导向装置治疗颅内动脉瘤的数据库，并纳入大脑中动脉动脉瘤患者。评估人口统计学、动脉瘤特征、并发症以及临床和血管造影结果。血管造影结果评估包括动脉瘤闭塞分级（奥凯利-马罗塔分级量表）、被栓塞分支的通畅情况以及支架内狭窄情况。
本研究纳入了8例患有8个大脑中动脉动脉瘤的患者。动脉瘤平均大小为11.8±6.8毫米。无手术相关并发症，平均随访11.3±3.6个月时无 morbidity 或 mortality。所有患者术后平均7.5±4.0个月进行了随访血管造影。8例患者中，奥凯利-马罗塔分级量表A 级1例（12.5%），B级3例（37.5%），C级1例（12.5%），D级3例（37.5%）。7例有被栓塞分支的患者中，4例（57.1%）被栓塞分支血流未改变，2例（28.6%）血流减少，1例（14.3%）血流闭塞。2例（25%）患者支架内狭窄为轻度，1例（12.5%）患者为中度。
中期结果表明，使用TuBridge血流导向装置对大脑中动脉动脉瘤进行血管内治疗是安全的，且预后良好。TuBridge血流导向装置可能是难以通过夹闭或栓塞治疗的复杂大脑中动脉动脉瘤的一种选择。
