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使用新型轮廓神经血管系统和NEQSTENT进行囊内血流干扰器辅助颅内动脉瘤栓塞术:单中心安全性和可行性研究

Intrasaccular Flow Disruptor-Assisted Coiling of Intracranial Aneurysms Using the Novel Contour Neurovascular Systems and NEQSTENT: A Single-Center Safety and Feasibility Study.

作者信息

Diana Francesco, de Dios Lascuevas Marta, Peschillo Simone, Raz Eytan, Yoshimura Shinichi, Requena Ruiz Manuel, Morales David Hernández, Tomasello Alejandro

机构信息

Neuroradiology, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', 84125 Salerno, Italy.

Neuroradiology, Vall d'Hebron Hospital Universitari, 08035 Barcelona, Spain.

出版信息

Brain Sci. 2022 Jul 26;12(8):991. doi: 10.3390/brainsci12080991.

Abstract

Intrasaccular flow disruptors (IFD) have been introduced in the treatment of intracranial aneurysms (IAs) to overcome the low aneurysm occlusion rate and the high recanalization rate of the coiling technique. Among them, the Contour Neurovascular System (CNS) and the Neqstent (NQS) were designed to reconstruct the aneurysmal neck and both can be used as assisting coiling devices. We aimed to report our preliminary experience with the flow disruptor-assisted coiling (IFD-AC) technique. We performed a retrospective analysis of prospectively collected data of all patients with IAs treated with the IFD-AC. Between February 2021 and April 2022, we treated 15 IAs with the IFD-AC: 10 ruptured and 5 unruptured. The IFD-AC was successfully performed in 13 cases, with a post-operative RROC 1 in 12 cases (92.3%) and RROC 2 in 1 case (7.7%). There was one ischemic event (6.7%) and no hemorrhagic complications. Twelve patients underwent a mid-term radiologic follow-up: Ten IAs (83.4%) presented an adequate occlusion, while 2 (16.7%) had a recurrence. The IFD-AC, both with the CNS and the NQS, seems a safe technique with promising efficacy profile. The IFD-AC has proved to be safe without antiplatelet therapy in ruptured cases. Further studies are needed to confirm our preliminary results.

摘要

囊内血流干扰装置(IFD)已被引入颅内动脉瘤(IA)的治疗,以克服弹簧圈栓塞技术的低动脉瘤闭塞率和高再通率。其中,轮廓神经血管系统(CNS)和Neqstent(NQS)旨在重建动脉瘤颈部,两者均可作为辅助弹簧圈栓塞装置使用。我们旨在报告我们在血流干扰装置辅助弹簧圈栓塞(IFD-AC)技术方面的初步经验。我们对前瞻性收集的所有接受IFD-AC治疗的IA患者的数据进行了回顾性分析。在2021年2月至2022年4月期间,我们用IFD-AC治疗了15例IA:10例破裂,5例未破裂。13例成功进行了IFD-AC,术后12例(92.3%)达到Raymond分级1级(RROC 1),1例(7.7%)达到RROC 2级。发生1例缺血事件(6.7%),无出血并发症。12例患者接受了中期影像学随访:10例IA(83.4%)显示闭塞良好,2例(16.7%)复发。使用CNS和NQS的IFD-AC似乎是一种安全的技术,疗效前景良好。IFD-AC已被证明在破裂病例中无需抗血小板治疗即可安全使用。需要进一步研究来证实我们的初步结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbd7/9394360/02a463ed4d90/brainsci-12-00991-g001.jpg

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