Department of Radiology, 60652Turku University Hospital, Turku, Finland.
Department of Clinical Radiology, 60650Kuopio University Hospital, Kuopio, Finland.
Neuroradiol J. 2023 Apr;36(2):206-212. doi: 10.1177/19714009221122216. Epub 2022 Aug 26.
To identify factors influencing short- and mid-term radiological outcomes of intracranial aneurysms (IAs) treated with the Woven EndoBridge (WEB).
A total of 112 patients were treated for IAs with the WEB in at our institution between 2013 and 2020. Patients with 6- and/or 24-months follow-up data were included in the study. Aneurysm occlusion was evaluated using the Raymond-Roy occlusion classification (RR). RR 1 and RR 2 were considered as adequate outcomes, while RR 3 inadequate.
Data were available for 91 patients (56 females, 62%) at 6 months and 62 of those patients (39 females, 58%) at 24 months. The adequate occlusion (RR 1/RR 2) rate was 89% ( = 81/91) at the 6-months follow-up and 91% ( = 56/62) at the 24-months follow-up. The treatment-related morbidity rate was 4% ( = 4/91), and mortality rate was 1% ( = 1/91). The predictor for inadequate occlusion at the 6-months follow-up was the lobular shape of an aneurysm ( = .01). The aneurysm's height ( = .02), maximal diameter ( = .001), width ( = .002), aspect ratio ( = .03), dome-to-neck ratio ( = .04), and lobular shape (= .03) were predictive factors for inadequate occlusion at 24 months. All the thrombosed aneurysms ( = 3) showed unfavorable radiological outcomes and required re-treatment within 24 months. None of the patient-related factors were significant.
The WEB provides favorable occlusion rates and low complications for both ruptured and unruptured wide-necked IAs. Unfavorable radiological outcomes after WEB treatment may be related to aneurysm morphology and size.
确定影响颅内动脉瘤（IA）患者采用编织型支架（WEB）治疗的短期和中期影像学结果的因素。
2013 年至 2020 年期间，我院对 112 例颅内动脉瘤患者采用 WEB 进行治疗。将有 6 个月和/或 24 个月随访数据的患者纳入本研究。采用 Raymond-Roy 闭塞分级（RR）评估动脉瘤闭塞情况。RR1 和 RR2 被认为是足够的结果，而 RR3 则被认为是不足够的。
共有 91 例患者（56 例女性，62%）在 6 个月时和其中 62 例患者（39 例女性，58%）在 24 个月时有随访数据。在 6 个月的随访中，充分闭塞（RR1/RR2）率为 89%（=81/91），在 24 个月的随访中为 91%（=56/62）。治疗相关的发病率为 4%（=4/91），死亡率为 1%（=1/91）。在 6 个月的随访中，影响闭塞不充分的预测因子是动脉瘤的分叶状形状（=0.01）。动脉瘤的高度（=0.02）、最大直径（=0.001）、宽度（=0.002）、长宽比（=0.03）、瘤颈比（=0.04）和分叶状形状（=0.03）是 24 个月时闭塞不充分的预测因素。所有血栓形成的动脉瘤（=3）均显示出不良的影像学结果，需要在 24 个月内进行再次治疗。患者相关的因素均无统计学意义。
WEB 为破裂和未破裂宽颈颅内动脉瘤提供了良好的闭塞率和低并发症。WEB 治疗后影像学结果不理想可能与动脉瘤的形态和大小有关。
