Li Jing, Gong Wentao, Li Dongdong, Song Wenpeng, Fan Feng, Yuan Yongjie, Li Youxiang, Guan Sheng
Department of Neurointervention Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2022 Oct 24;13:1029699. doi: 10.3389/fneur.2022.1029699. eCollection 2022.
The risk of perioperative stroke and the rate of occlusion of long-term aneurysms in the treatment of unruptured aneurysms with flow diverters (FDs) are affected by stent apposition. Optical coherence tomography (OCT) may be an optional technique in evaluating apposition.
To explore the feasibility of the OCT imaging technique in evaluating stent apposition in the clinical application of the FD for unruptured aneurysms.
OCT and Vaso CT were used in patients with indications for surgery to treat unruptured aneurysms with the FDs, to evaluate the apposition of the FDs after fully released, and to analyze OCT images for FDs apposition and compare with corresponding Vaso CT images.
A total of four patients were enrolled, and OCT found malapposition after FDs placement in all four patients, and the maximum gap between the stent and vascular wall ranged from 0.68 to 1.95 mm and the length of malapposition ranged from 1.80 to 7.40 mm. However, Vaso CT found malapposition only in two of the four patients and missed malapposition near aneurysm in all three patients treated by the FD combined with coiling and could not accurately evaluate the maximum gap and the length of the malapposition.
The optical coherence tomography technique is a possible approach to evaluate apposition after the treatment of unruptured aneurysms by the FDs.
在使用血流导向装置（FD）治疗未破裂动脉瘤时，围手术期卒中风险及长期动脉瘤闭塞率受支架贴壁情况影响。光学相干断层扫描（OCT）可能是评估贴壁情况的一种可选技术。
探讨OCT成像技术在评估FD治疗未破裂动脉瘤临床应用中支架贴壁情况的可行性。
对有手术指征、使用FD治疗未破裂动脉瘤的患者采用OCT和血管造影CT，评估FD完全释放后的贴壁情况，分析FD贴壁的OCT图像并与相应血管造影CT图像进行比较。
共纳入4例患者，OCT发现4例患者在放置FD后均存在贴壁不良，支架与血管壁之间的最大间隙为0.68至1.95毫米，贴壁不良长度为1.80至7.40毫米。然而，血管造影CT仅在4例患者中的2例发现贴壁不良，在所有3例采用FD联合弹簧圈治疗的患者中均未发现动脉瘤附近的贴壁不良，且无法准确评估贴壁不良的最大间隙和长度。
光学相干断层扫描技术是评估FD治疗未破裂动脉瘤后贴壁情况的一种可行方法。
