Zhou Yangyang, Wu Xinzhi, Tian Zhongbin, Yang Xinjian, Mu Shiqing
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2020 Oct 30;11:522583. doi: 10.3389/fneur.2020.522583. eCollection 2020.
To evaluate effectiveness and safety of Pipeline embolization device (PED) for large or giant verterbrobasilar aneurysms (LGVBAs), and to compare the therapeutic effects of PED with and without adjunctive coils. We retrospectively analyzed 21 cases of unruptured LGVBAs who were treated in our hospital with PED. These cases were divided into "PED group" and "PED with adjunctive coils group." We compared the aneurysm characteristics and treatment outcomes between the two groups. The overall neurological complication rate was 28.6% (6/21) and the mortality rate was 4.8% (1/21). There were 12 patients in the PED group and nine in the PED with adjunctive coils group. There were no significant differences in age, smoking, hypertension, aneurysm size, aneurysm location, or operation time between the two groups. The complete aneurysm embolization rate and favorable outcome rate (modified Rankin Scale = 0,1) of the PED with adjunctive coils group was 78% (7/9) and 100% (9/9), respectively, which were both better compared with the PED group with 63.6% (7/11) and 83% (10/12), respectively. However, these differences were not statistically significant. The effectiveness and safety of PED for LGVBAs is acceptable. Treatment results did not differ between the PED and PED with adjunctive coils groups; therefore, whether coils should be used may depend the operator. Our results suggest that correct use of the coils does not increase complications. We suggest that PED with adjunctive coils should be used for some selected LGVBAs.
评估 Pipeline 栓塞装置（PED）治疗大型或巨大型椎基底动脉瘤（LGVBA）的有效性和安全性，并比较使用和不使用辅助弹簧圈时 PED 的治疗效果。我们回顾性分析了在我院接受 PED 治疗的 21 例未破裂 LGVBA 患者。这些病例被分为“PED 组”和“PED 联合辅助弹簧圈组”。我们比较了两组之间的动脉瘤特征和治疗结果。总体神经并发症发生率为 28.6%（6/21），死亡率为 4.8%（1/21）。PED 组有 12 例患者，PED 联合辅助弹簧圈组有 9 例患者。两组在年龄、吸烟、高血压、动脉瘤大小、动脉瘤位置或手术时间方面无显著差异。PED 联合辅助弹簧圈组的动脉瘤完全栓塞率和良好预后率（改良 Rankin 量表 = 0,1）分别为 78%（7/9）和 100%（9/9），均优于 PED 组，PED 组分别为 63.6%（7/11）和 83%（10/12）。然而，这些差异无统计学意义。PED 治疗 LGVBA 的有效性和安全性是可以接受的。PED 组和 PED 联合辅助弹簧圈组的治疗结果无差异；因此，是否使用弹簧圈可能取决于操作者。我们的结果表明，正确使用弹簧圈不会增加并发症。我们建议对于一些选定的 LGVBA 应使用 PED 联合辅助弹簧圈。
