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使用LVIS Jr.装置对未破裂大脑中动脉动脉瘤进行支架辅助弹簧圈栓塞术:一项多中心注册研究

Stent-Assisted Coiling of Unruptured MCA Aneurysms Using the LVIS Jr. Device: A Multicenter Registry.

作者信息

Poncyljusz Wojciech, Zwarzany Łukasz, Limanówka Bartosz, Zbroszczyk Miłosz, Banach Mariusz, Bereza Sławomir, Sagan Leszek

机构信息

Department of Diagnostic Imaging and Interventional Radiology, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland.

Department of Neurosurgery and Pediatric Neurosurgery, Pomeranian Medical University, Unii Lubelskiej 1, 71-252 Szczecin, Poland.

出版信息

J Clin Med. 2020 Sep 30;9(10):3168. doi: 10.3390/jcm9103168.

Abstract

The low-profile visualized intraluminal support junior (LVIS Jr.) is a new generation low-profile braided stent. Our aim was to evaluate the safety and efficacy of the LVIS Jr. in the stent-assisted coiling of unruptured middle cerebral artery (MCA) aneurysms. This was a multicenter retrospective study. Patient demographics, aneurysm characteristics, procedural details, complications, and the results of clinical and imaging follow-up were analyzed. Four centers participated in the study. A total of 162 consecutive patients with 162 unruptured MCA aneurysms were included for the analysis. The mean aneurysm size was 7.6 mm (range 2 to 37 mm) and 97.5% were wide-necked. Immediate postprocedural angiograms showed Raymond-Roy class 1 in 118 (72.8%), class 2 in 23 (14.2%), and class 3 in 21 patients (13%). Periprocedural complications occurred in 14 patients (8.6%). There were no procedure-related deaths. Follow-up imaging at 12-18 months post-procedure showed Raymond-Roy class 1 in 132 (81.5%), class 2 in 17 (10.5%), and class 3 in 13 patients (8%). There were 3 cases of in-stent stenosis (1.9%). All 162 patients had good clinical outcome (mRS score 0-2) at 90 days post-procedure. Stent-assisted coiling of unruptured MCA aneurysms with the LVIS Jr. stent is safe and effective, with high immediate and long-term total occlusion rates.

摘要

低轮廓可视化腔内支撑小号支架(LVIS Jr.)是新一代的低轮廓编织支架。我们的目的是评估LVIS Jr.在未破裂大脑中动脉(MCA)动脉瘤支架辅助栓塞中的安全性和有效性。这是一项多中心回顾性研究。分析了患者的人口统计学特征、动脉瘤特征、手术细节、并发症以及临床和影像学随访结果。四个中心参与了该研究。共有162例连续患者的162个未破裂MCA动脉瘤纳入分析。动脉瘤平均大小为7.6毫米(范围2至37毫米),97.5%为宽颈动脉瘤。术后即刻血管造影显示,118例(72.8%)为Raymond-Roy 1级,23例(14.2%)为2级,21例(13%)为3级。围手术期并发症发生在14例患者(8.6%)。无手术相关死亡。术后12 - 18个月的随访影像学显示,132例(81.5%)为Raymond-Roy 1级,17例(10.5%)为2级,13例(8%)为3级。有3例支架内狭窄(1.9%)。所有这162例患者在术后90天时临床预后良好(mRS评分0 - 2)。使用LVIS Jr.支架对未破裂MCA动脉瘤进行支架辅助栓塞是安全有效的,即刻和长期的完全闭塞率都很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/093a/7601776/a924263db241/jcm-09-03168-g001.jpg

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