Lauzier David C, Cler Samuel J, Chatterjee Arindam R, Osbun Joshua W, Moran Christopher J, Kansagra Akash P
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
J Neurointerv Surg. 2022 Jun;14(6):585-588. doi: 10.1136/neurintsurg-2021-017745. Epub 2021 Jul 1.
Flow diversion of intracranial aneurysms with the Pipeline Embolization Device (PED) is commonly performed, but the value of long-term angiographic follow-up has not been rigorously evaluated. Here we examine the prevalence of actionable findings of aneurysm recurrence and development of in-stent stenosis in a cohort of patients that underwent long-term angiographic follow-up at multiple time points.
Angiographic data from eligible patients were retrospectively assessed for aneurysm occlusion, in-stent stenosis, and aneurysm regrowth or recurrence. Patients were included in this study if they underwent angiographic imaging at 6 months post-treatment and at least one later time point.
100% (132/132) of aneurysms occluded at 6 months remained occluded at final follow-up. 85.7% (6/7), 56.3% (27/48), and 25% (6/24) of aneurysms with entry remnant, subtotal filling, and total filling, respectively, at 6 months were completely occluded at final follow-up. 98.7% (147/149) of PED constructs that demonstrated no stenosis at 6 months demonstrated no stenosis at final angiography, while 44.4% (8/18) of PED constructs demonstrating in-stent stenosis at 6 months had resolution of stenosis on final angiography.
Among patients who undergo treatment of intracranial aneurysms with PED, the value of long-term angiography in patients demonstrating complete aneurysm occlusion and no in-stent stenosis on 6 month post-treatment angiography is low.
使用Pipeline栓塞装置（PED）对颅内动脉瘤进行血流导向治疗已广泛开展，但长期血管造影随访的价值尚未得到严格评估。在此，我们在一组接受多个时间点长期血管造影随访的患者中，研究动脉瘤复发和支架内狭窄发展的可处理性发现的发生率。
对符合条件患者的血管造影数据进行回顾性评估，以确定动脉瘤闭塞、支架内狭窄以及动脉瘤再生长或复发情况。如果患者在治疗后6个月及至少一个后续时间点接受了血管造影成像，则纳入本研究。
在6个月时闭塞的动脉瘤中，100%（132/132）在最终随访时仍保持闭塞。在6个月时分别有入口残余、部分充盈和完全充盈的动脉瘤中，最终随访时完全闭塞的比例分别为85.7%（6/7）、56.3%（27/48）和25%（6/24）。在6个月时无狭窄的PED装置中，98.7%（147/149）在最终血管造影时仍无狭窄，而在6个月时显示支架内狭窄的PED装置中，44.4%（8/18）在最终血管造影时狭窄消失。
在接受PED治疗颅内动脉瘤的患者中，对于治疗后6个月血管造影显示动脉瘤完全闭塞且无支架内狭窄的患者，长期血管造影的价值较低。
