Wang Chuanchuan, Zhu Deyuan, Xu Xiaolong, Zhou Yu, Zhao Rui, Li Qiang, Yang Pengfei, Huang Qinghai, Xu Yi, Liu Jianmin, Fang Yibin
Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Department of Neurovascular Disease, School of Medicine, Shanghai Fourth People's Hospital, Tongji University, Shanghai, China.
Front Neurol. 2022 Aug 17;13:990308. doi: 10.3389/fneur.2022.990308. eCollection 2022.
Flow diverters (FDs) for the treatment of basilar artery (BA) aneurysms remain controversial. In this study, we report our initial experience of flow diversion for treatment of this pathology.
Consecutive patients with an aneurysm of the BA that was treated by implantation of the FD were included in our retrospective study. Procedural complications, aneurysm occlusion, and a functional outcome were evaluated. FD placement in BA for aneurysm treatment reported in the literature was also reviewed and summarized.
Sixteen patients with 16 BA aneurysms were treated by FD implantation with ( = 8) or without ( = 8) adjunctive coiling. The Tubridge was used in 13 (81.3%) and Pipeline in 3 (18.8%) procedures. Average aneurysm size was 15.7 mm. Four aneurysms were located at the basilar apex, six at the basilar trunk, and six at the vertebrobasilar junction. Three patients experienced procedural complications (18.8%), including two ischemic strokes and one hydrocephalus, with resultant mortality in one case (6.3%). Median follow-up was 7.7 months and available for 15 aneurysms. Complete/near-complete occlusion was seen in 13 (86.7%) aneurysms.
In our initial experience, flow diversion is feasible and safe in the treatment of BA aneurysms with promising occlusion rates at mid-term follow-up. Larger cohort studies are required to validate these results.
用于治疗基底动脉（BA）动脉瘤的血流导向装置（FD）仍存在争议。在本研究中，我们报告了我们采用血流导向治疗这种疾病的初步经验。
我们的回顾性研究纳入了连续的因植入FD治疗BA动脉瘤的患者。评估了手术并发症、动脉瘤闭塞情况和功能结局。我们还对文献中报道的将FD置于BA治疗动脉瘤的情况进行了回顾和总结。
16例患有16个BA动脉瘤的患者接受了FD植入治疗，其中8例（50%）联合弹簧圈栓塞，8例（50%）未联合。13例（81.3%）使用了Tubridge装置，3例（18.8%）使用了Pipeline装置。动脉瘤平均大小为15.7 mm。4个动脉瘤位于基底动脉顶端，6个位于基底动脉主干，6个位于椎基底动脉交界处。3例患者出现手术并发症（18.8%），包括2例缺血性卒中、1例脑积水，其中1例死亡（6.3%）。中位随访时间为7.7个月，15个动脉瘤可进行评估。13个（86.7%）动脉瘤实现了完全/近完全闭塞。
根据我们的初步经验，血流导向治疗BA动脉瘤是可行且安全的，中期随访时动脉瘤闭塞率令人满意。需要更大规模的队列研究来验证这些结果。
