Department of Neurosurgery, Changhai Hospital, Navy Military Medical University, Shanghai 200433, People's Republic of China; Naval Medical Center of PLA, Navy Military Medical University, Shanghai 200050, People's Republic of China.
Department of Neurosurgery, Changhai Hospital, Navy Military Medical University, Shanghai 200433, People's Republic of China.
J Clin Neurosci. 2022 Jun;100:131-137. doi: 10.1016/j.jocn.2022.04.014. Epub 2022 Apr 19.
Treatment of complex intracranial aneurysms (IAs) is still a challenging thing and this study aims to summarize the experience of telescoping flow diverters (FDs) in treating complex intracranial aneurysms.
Between April 2013 to November 2020, 381 IA cases treated by flow diverters (FD) were retrieved from the database of 4988 IA cases, and finally 20 cases treated by telescoping FDs were enrolled for further analysis.
Among 20 patients, 15 patients (75.0%) received Tubridge telescoping while 5 patients (25.0%) received PED telescoping. The technical success rate was 100%. The immediate occlusion results were: 7 cases of OKM grade A (35.0%), 11 cases of OKM grade B (55.0%), and 2 cases of OKM grade C (10.0%). No perioperative complications occurred. The clinical follow-up was available in 20 patients (100%) and the follow-up time was 6-96 months. One patient developed massive infarction and the other 19 patients were range between 0 and 2. The angiographic follow-up was available in 17 patients (85%) and the follow-up time was 6-27 months. The occlusion results were: 1 case of OKM grade B (5.9%), 6 cases of OKM grade C (35, 0.3%), and 10 cases of OKM grade D (58.8%). 2 patients (11.8%) developed occlusion of the patent artery.
Telescoping flow diverters showed low perioperative complications and high IA occlusion rate when treating complex intracranial aneurysms in follow-up time, which provides an alternative manner beyond conventional strategy for neurosurgeons.
治疗复杂颅内动脉瘤（IA）仍然是一件具有挑战性的事情，本研究旨在总结伸缩式血流导向装置（FD）治疗复杂颅内动脉瘤的经验。
2013 年 4 月至 2020 年 11 月，从 4988 例 IA 病例数据库中检索到 381 例接受 FD 治疗的 IA 病例，最终纳入 20 例接受伸缩 FD 治疗的患者进行进一步分析。
20 例患者中，15 例（75.0%）接受 Tubridge 伸缩，5 例（25.0%）接受 PED 伸缩。技术成功率为 100%。即刻闭塞结果为：7 例 OKM 分级 A（35.0%），11 例 OKM 分级 B（55.0%），2 例 OKM 分级 C（10.0%）。无围手术期并发症。20 例患者（100%）获得临床随访，随访时间为 6-96 个月。1 例患者发生大面积梗死，其余 19 例患者为 0-2 级。17 例患者（85%）获得血管造影随访，随访时间为 6-27 个月。闭塞结果为：1 例 OKM 分级 B（5.9%），6 例 OKM 分级 C（35.0%），10 例 OKM 分级 D（58.8%）。2 例患者（11.8%）出现载瘤动脉闭塞。
在随访期间，伸缩式血流导向装置治疗复杂颅内动脉瘤具有较低的围手术期并发症和较高的颅内动脉瘤闭塞率，为神经外科医生提供了一种替代传统策略的方法。
