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颅内动脉瘤血流导向装置植入术后神经并发症的发生时间及范围

Timing and Spectrum of Neurological Complications After Flow Diverter Implantation for Intracranial Aneurysms.

作者信息

Charbonnier Guillaume, Desilles Jean-Philippe, Escalard Simon, Maier Benjamin, Ciccio Gabriele, Smajda Stanislas, Fahed Robert, Delvoye François, Redjem Hocine, Blanc Raphaël, Piotin Michel, Mazighi Mikael

机构信息

Interventional Neuroradiology, Besançon University Hospital, Besancon, France.

Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France.

出版信息

Front Neurol. 2021 Apr 20;12:590383. doi: 10.3389/fneur.2021.590383. eCollection 2021.

Abstract

The aim of this study was to characterize neurological complications after flow diverter (FD) treatment on a long follow-up cohort and identify predictive factors associated with these complications. This study was conducted on a monocentric cohort of patients treated for intracranial aneurysms by FD. Between September 2008 and July 2018, 413 patients were treated for 514 aneurysms: 18% of the patients presented with at least one neurological complication during a median follow-up of 446 days (IQR 186-1,210). Sixty-one patients presented with ischemic complications, 13 with hemorrhagic ones and 10 with compressive processes. Among 89 neurological complications 64.5% were peri-operative (occurring within the 30 days following the procedure) and 35.5% were delayed after 1 month. Overall, neurological complications after FD implantation were overrepresented by cerebrovascular ischemic events occurring during the peri-operative period, but also in a delayed manner after 1 year. Long-term follow-up is relevant after aneurysm intervention using FD.

摘要

本研究的目的是对长期随访队列中血流导向装置(FD)治疗后的神经并发症进行特征描述,并确定与这些并发症相关的预测因素。本研究针对单中心队列中接受FD治疗颅内动脉瘤的患者开展。2008年9月至2018年7月期间,413例患者接受了514个动脉瘤的治疗:在中位随访446天(四分位间距186 - 1210天)期间,18%的患者出现至少一种神经并发症。61例患者出现缺血性并发症,13例出现出血性并发症,10例出现压迫性病变。在89例神经并发症中,64.5%为围手术期(术后30天内发生),35.5%在1个月后延迟出现。总体而言,FD植入后的神经并发症以围手术期发生的脑血管缺血事件为主,但1年后也会出现延迟性事件。使用FD进行动脉瘤干预后进行长期随访很有必要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/524a/8093792/3fceeeb44c86/fneur-12-590383-g0001.jpg

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