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超越颅内动脉瘤栓塞系统治疗大型或巨大宽颈动脉瘤的关键试验 - SCENT:3年结果

Surpass Intracranial Aneurysm Embolization System Pivotal Trial to Treat Large or Giant Wide-Neck Aneurysms - SCENT: 3-year outcomes.

作者信息

Hanel Ricardo A, Cortez Gustavo M, Coon Alexander L, Kan Peter, Taussky Philipp, Wakhloo Ajay K, Welch Babu G, Dogan Aclan, Bain Mark, De Vries Joost, Ebersole Koji, Meyers Philip M

机构信息

Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA

Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.

出版信息

J Neurointerv Surg. 2023 Nov;15(11):1084-1089. doi: 10.1136/jnis-2022-019512. Epub 2022 Nov 14.

Abstract

BACKGROUND

To report the 3-year safety and effectiveness of the Surpass Streamline flow diverter in the SCENT trial (Surpass Intracranial Aneurysm Embolization System Pivotal Trial to Treat Large or Giant Wide-Neck Aneurysms).

METHODS

The Surpass Streamline flow diverter device was evaluated in a multicenter, prospective, single-arm, non-randomized interventional trial including patients with uncoilable or previously treated but failed aneurysms of the intracranial internal carotid artery. 3-year outcomes were tabulated with descriptive statistics and compared with 1-year outcomes.

RESULTS

Of 180 patients in the modified intent-to-treat (mITT) cohort, 36-month clinical and angiographic follow-up was available in 134 and 117 cases, respectively. Effectiveness endpoint of complete aneurysm occlusion without clinically significant stenosis or retreatment was met in 71.8% (79/110, 95% CI 62.4% to 80.0%) of cases. Safety composite endpoint was 12.2% (22/180) over the 3-year period, with two major safety events (ipsilateral ischemic strokes) occurring between 12-36 months. Complete aneurysm occlusion was noted in 77.8% (91/117), and 99.1% (116/117) of the patients demonstrated adequate aneurysm occlusion (complete occlusion or neck residual). There were four cases (2.2%) of aneurysm rupture, all occurring within the first month of the index procedure. Target aneurysm retreatment rate was 2.8% (5/180).

CONCLUSION

The present findings support the long-term safety and effectiveness of the Surpass Streamline flow diverter device.

TRIAL REGISTRATION

NCT01716117.

摘要

背景

报告在SCENT试验(用于治疗大型或巨大宽颈动脉瘤的Surpass颅内动脉瘤栓塞系统关键试验)中Surpass Streamline血流导向装置的3年安全性和有效性。

方法

在一项多中心、前瞻性、单臂、非随机干预试验中对Surpass Streamline血流导向装置进行评估,该试验纳入了无法进行线圈栓塞或先前治疗但失败的颅内颈内动脉瘤患者。用描述性统计方法列出3年的结果,并与1年的结果进行比较。

结果

在改良意向性治疗(mITT)队列的180例患者中,分别有134例和117例获得了36个月的临床和血管造影随访。71.8%(79/110,95%CI 62.4%至80.0%)的病例达到了无临床显著狭窄或再次治疗的完全动脉瘤闭塞有效性终点。3年期间安全综合终点为12.2%(22/180),在12至36个月之间发生了两起重大安全事件(同侧缺血性卒中)。77.8%(91/117)的患者实现了完全动脉瘤闭塞,99.1%(116/117)的患者显示动脉瘤闭塞充分(完全闭塞或颈部残留)。有4例(2.2%)动脉瘤破裂,均发生在首次手术的第一个月内。目标动脉瘤再治疗率为2.8%(5/180)。

结论

目前的研究结果支持Surpass Streamline血流导向装置的长期安全性和有效性。

试验注册

NCT01716117。

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