Department of Radiology, 159397Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Shanghai 200040, China.
Interv Neuroradiol. 2023 Apr;29(2):165-171. doi: 10.1177/15910199221081249. Epub 2022 Mar 2.
To compare the technical performance and outcomes of Solitaire and Neuroform stents for treatment of intracranial bifurcation aneurysms (IBAs).
IBAs treated by stent-assisted coiling using a Solitaire or Neuroform stent between October 2010 and December 2019 were retrospectively evaluated. Patient demographics, aneurysm information, treatment technique, periprocedural and device-related complications, parent artery angle change, along with initial and follow-up angiographic results were analyzed.
One hundred twenty-one patients with 121 IBAs treated with Solitaire (n = 101) or Neuroform (n = 20) stent-assisted coiling were included. Aneurysm size, thrombotic and hemorrhagic complication rate, initial occlusion rate and in-stent stenosis between the two cohorts were not significantly different. Aneurysm location was significantly different between the two groups (p = 0.032). Jailing technique rate for coiling was significantly higher in the Solitaire than the Neuroform group (70.3% vs. 35.0%, p < 0.01). Follow-up DSA demonstrated a significantly lower recurrence rate for the Solitaire cohort (2.9% vs. 22.2%, p = 0.016). Parent artery angle changes, immediately post-operative and on follow-up were significantly greater in the Solitaire stent group (p < 0.05).
For intracranial bifurcation aneurysms, Solitaire stent-assisted coiling achieved a significantly lower recurrence rate and induced more favorable parent artery angular remodeling than Neuroform stenting.
比较 Solitaire 和 Neuroform 支架治疗颅内分叉部动脉瘤(IBAs)的技术性能和结果。
回顾性分析 2010 年 10 月至 2019 年 12 月采用 Solitaire 或 Neuroform 支架辅助弹簧圈治疗的 IBA 患者。分析患者的人口统计学资料、动脉瘤信息、治疗技术、围手术期和器械相关并发症、母动脉角度变化以及初始和随访血管造影结果。
共纳入 121 例采用 Solitaire(n=101)或 Neuroform(n=20)支架辅助弹簧圈治疗的 121 例 IBA 患者。两组患者的动脉瘤大小、血栓和出血性并发症发生率、初始闭塞率和支架内狭窄率无显著差异。两组患者的动脉瘤位置存在显著差异(p=0.032)。Solitaire 组的线圈填塞技术率明显高于 Neuroform 组(70.3%比 35.0%,p<0.01)。随访 DSA 显示 Solitaire 组的复发率明显较低(2.9%比 22.2%,p=0.016)。Solitaire 支架组母动脉角度的变化,术后即刻和随访时均显著大于 Neuroform 支架组(p<0.05)。
对于颅内分叉部动脉瘤,Solitaire 支架辅助弹簧圈治疗的复发率明显较低,且引起的母动脉角度重塑更为有利。