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新型 LVIS EVO 装置辅助支架弹簧圈栓塞颅内动脉瘤的围手术期安全性和可行性:一项观察性多中心研究。

Periprocedural Safety and Feasibility of the New LVIS EVO Device for Stent-Assisted Coiling of Intracranial Aneurysms: An Observational Multicenter Study.

机构信息

From the Department of Neuroradiology (D.F.V., C.H., M.B., M.A.M.), Heidelberg University Hospital, Heidelberg, Germany.

Department of Diagnostic and Interventional Radiology and Neuroradiology (A.B., C.M., L.B.), Universitätsklinikum Augsburg, Augsburg, Germany.

出版信息

AJNR Am J Neuroradiol. 2021 Jan;42(2):319-326. doi: 10.3174/ajnr.A6887. Epub 2020 Dec 10.

Abstract

BACKGROUND AND PURPOSE

Stent-assisted treatment techniques can be an effective treatment option for intracranial aneurysms. The aim of this study was to evaluate the periprocedural feasibility and safety of the new LVIS EVO stent for the treatment of intracranial aneurysms.

MATERIALS AND METHODS

Patients with intracranial aneurysms treated with the LVIS EVO in 11 European neurovascular centers were retrospectively reviewed. Patient and aneurysm characteristics, procedural parameters, immediate grade of occlusion, and technical and clinical complications were assessed.

RESULTS

Fifty-seven patients with 59 aneurysms were treated with the LVIS EVO device; 57.6% of the aneurysms were incidental; 15.3% were acutely ruptured; 15.3% were recanalized or residual aneurysms; and 11.9% were treated for symptoms other than acute hemorrhage. The most frequent aneurysm locations were the middle cerebral artery (25.4%) and the anterior communicating artery (22.0%). The rate of immediate successful deployment was 93.2%. In 6.8% ( = 4) of cases, additional in-stent angioplasty was needed. The immediate complete occlusion rate was 54.2%, while there was a residual aneurysm in 35.6% and a residual neck in 10.2%. Periprocedural technical complications occurred in 7/59 treatments (11.9%; the most frequent technical complication [ = 3] was thrombus formation), which all resolved completely without clinical sequelae. Postprocedural neurologic complications occurred after 4/59 treatments (6.8%; 2 transient ischemic attacks, 1 minor stroke, 1 major stroke), of which only 1 persistent complication was directly related to the procedure (minor stroke in the vascular territory distal to the stent).

CONCLUSIONS

The LVIS EVO stent is a safe, feasible device for the treatment of intracranial aneurysms.

摘要

背景与目的

支架辅助治疗技术可为颅内动脉瘤提供有效的治疗选择。本研究旨在评估新型 LVIS EVO 支架治疗颅内动脉瘤的围手术期可行性和安全性。

材料与方法

回顾性分析 11 个欧洲神经血管中心采用 LVIS EVO 治疗的颅内动脉瘤患者。评估患者和动脉瘤特征、手术参数、即刻闭塞程度以及技术和临床并发症。

结果

57 例患者的 59 个动脉瘤采用 LVIS EVO 装置治疗;57.6%的动脉瘤为偶发性;15.3%为急性破裂;15.3%为再通或残留动脉瘤;11.9%为治疗急性出血以外的症状。最常见的动脉瘤部位是大脑中动脉(25.4%)和前交通动脉(22.0%)。即刻成功展开率为 93.2%。在 6.8%(=4)的病例中,需要额外进行支架内血管成形术。即刻完全闭塞率为 54.2%,而有 35.6%存在残留动脉瘤,10.2%存在残留瘤颈。围手术期技术并发症发生在 7/59 例治疗中(11.9%;最常见的技术并发症[=3]是血栓形成),所有并发症均完全解决,无临床后遗症。术后神经并发症发生在 4/59 例治疗后(6.8%;2 例短暂性脑缺血发作,1 例轻度卒中,1 例重度卒中),仅 1 例持续性并发症与手术直接相关(支架远端血管区域的轻度卒中)。

结论

LVIS EVO 支架是治疗颅内动脉瘤安全、可行的装置。

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