LVIS 或 LVIS Jr. 与 Enterprise VRD 支架辅助弹簧圈栓塞治疗未破裂颈内动脉动脉瘤的比较：回顾性单中心分析。
Comparison of Stent-Assisted Coiling for Unruptured Internal Carotid Artery Aneurysms Between LVIS or LVIS Jr. and Enterprise VRD: A Retrospective and Single-Center Analysis.
机构信息
Asahikawa Medical University, Department of Neurosurgery, Hokkaido, Japan.
出版信息
Turk Neurosurg. 2021;31(3):379-384. doi: 10.5137/1019-5149.JTN.31089-20.2.
AIM
To compare the low-profile visualized intraluminal support (LVIS or LVIS Jr.) stent, which is a braided microstent, and Enterprise Vascular Reconstructive Device (VRD), which is fabricated using laser cutting technology, in the treatment of internal carotid artery aneurysms.
MATERIAL AND METHODS
We investigated 49 unruptured aneurysm cases in which follow-up digital subtraction angiography had been performed. Results of the occlusion were divided into classes 1, 2, and 3 of the Raymond-Roy Occlusion Classification. Statistical significance was defined as p < 0.05.
RESULTS
In the 49 aneurysm cases, we achieved class 1 in 23 (47%; LVIS or LVIS Jr., 7; Enterprise, 16; p=0.76), class 2 in 13 (27%; LVIS or LVIS Jr., 5; Enterprise, 8; p=0.74), and class 3 in 13 (27%; LVIS or LVIS Jr., 5; Enterprise, 8; p=0.74). Based on the follow-up imaging of the 49 aneurysms, we achieved class 1 in 32 cases (65%; LVIS or LVIS Jr., 16; Enterprise, 16; p < 0.01), class 2 in 7 (14%; LVIS or LVIS Jr., 0; Enterprise, 7; p < 0.01), and class 3 in 10 (20%; LVIS or LVIS Jr., 1; Enterprise, 9; p=0.13).
CONCLUSION
Recently, the flow diversion effect of stents has garnered more attention compared to coil embolization. LVIS or LVIS Jr. exerts a higher flow diversion effect than other stents and may improve the Raymond-Roy Occlusion Classification. In the future, the role of stents in the treatment of aneurysms will become more important.
目的
比较采用编织微支架技术的低轮廓可视化腔内支撑（LVIS 或 LVIS Jr.）支架和采用激光切割技术制造的 Enterprise 血管重建装置（VRD）在治疗颈内动脉动脉瘤中的效果。
材料和方法
我们研究了 49 例未破裂的动脉瘤病例，这些病例均进行了随访数字减影血管造影。闭塞结果分为 Raymond-Roy 闭塞分类的 1 类、2 类和 3 类。统计学意义定义为 p<0.05。
结果
在 49 例动脉瘤病例中，我们在 23 例（47%；LVIS 或 LVIS Jr.，7 例；Enterprise，16 例；p=0.76）中达到 1 类，在 13 例（27%；LVIS 或 LVIS Jr.，5 例；Enterprise，8 例；p=0.74）中达到 2 类，在 13 例（27%；LVIS 或 LVIS Jr.，5 例；Enterprise，8 例；p=0.74）中达到 3 类。基于对 49 例动脉瘤的随访影像学检查，我们在 32 例（65%；LVIS 或 LVIS Jr.，16 例；Enterprise，16 例；p<0.01）中达到 1 类，在 7 例（14%；LVIS 或 LVIS Jr.，0 例；Enterprise，7 例；p<0.01）中达到 2 类，在 10 例（20%；LVIS 或 LVIS Jr.，1 例；Enterprise，9 例；p=0.13）中达到 3 类。
结论
最近，支架的血流改道效果比线圈栓塞引起了更多的关注。LVIS 或 LVIS Jr. 比其他支架产生更高的血流改道效果，可能改善 Raymond-Roy 闭塞分类。在未来，支架在动脉瘤治疗中的作用将变得更加重要。
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