Department of Radiology, Turku University Hospital, Turku, Finland.
Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK.
Interv Neuroradiol. 2024 Aug;30(4):517-523. doi: 10.1177/15910199221139542. Epub 2022 Nov 17.
The aim of our multi-center study is to examine 5-year radiological outcomes of intracranial aneurysms (IAs) treated with the Woven EndoBridge (WEB).
All patients treated with WEB between January 2013 and December 2016 were included. Patient and aneurysm characteristic data was collected from the electronic patient record. Aneurysm occlusion was assessed using a 3-grade scale: complete occlusion, neck remnant, and aneurysm remnant. Complete occlusion and neck remnant were considered as adequate occlusion, whereas aneurysm remnant was assessed as an inadequate occlusion.
A total of 66 patients (72.7% female) with 66 IAs (n = 25 acutely ruptured) were treated with WEB. The mean age of patients was 55.6 years (range: 36-71 years). The mean width of the aneurysm neck was 4.5 mm (range: 2-9 mm). 5-year imaging follow-up data was not available for 16.6% patients (n = 11). During the follow up period, 14.5% of IAs (n = 8/55) required retreatment within 24 months of initial treatment with the WEB. A total of 55 IAs were analyzed for 5-year radiological outcome. Of these, including IAs required retreatment, 47.3% of IAs (n = 26/55) were occluded completely, 36.4% (n = 20/55) had neck remnant and 16.3% (n = 9/55) had recanalized. 83.7% of IAs were occluded adequately. None of the IAs rebled after initial treatment with WEB.
WEB can provide acceptable adequate occlusion rates at 5 years. Furthermore, recanalization appears to be unlikely after the first two years post-treatment. The results of large studies are needed to confirm these promising long term radiological outcomes.
我们的多中心研究旨在检查使用编织型颅内支架(WEB)治疗颅内动脉瘤(IA)的 5 年影像学结果。
纳入 2013 年 1 月至 2016 年 12 月期间接受 WEB 治疗的所有患者。从电子病历中收集患者和动脉瘤特征数据。使用 3 级评分评估动脉瘤闭塞情况:完全闭塞、瘤颈残留和动脉瘤残留。完全闭塞和瘤颈残留被认为是充分闭塞,而动脉瘤残留被评估为不充分闭塞。
共 66 例患者(72.7%为女性),66 个颅内动脉瘤(25 个为急性破裂)接受 WEB 治疗。患者的平均年龄为 55.6 岁(范围:36-71 岁)。动脉瘤颈的平均宽度为 4.5mm(范围:2-9mm)。16.6%的患者(n=11)未获得 5 年影像学随访数据。在随访期间,14.5%的颅内动脉瘤(n=8/55)在 WEB 初始治疗后 24 个月内需要再次治疗。对 55 个颅内动脉瘤进行了 5 年影像学结果分析,包括需要再次治疗的颅内动脉瘤。其中,包括需要再次治疗的颅内动脉瘤,47.3%(n=26/55)完全闭塞,36.4%(n=20/55)瘤颈残留,16.3%(n=9/55)再通。83.7%的颅内动脉瘤得到充分闭塞。WEB 初始治疗后,无颅内动脉瘤再出血。
WEB 在 5 年内可提供可接受的充分闭塞率。此外,在治疗后前两年内再通似乎不太可能。需要大型研究的结果来证实这些有前途的长期影像学结果。