Cerebrovascular Department of Interventional Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan province, China.
Neurosurgery Department of Stroke Center, Henan Provincial People's, Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, China.
Neurosurgery. 2023 May 1;92(5):971-978. doi: 10.1227/neu.0000000000002319. Epub 2022 Dec 29.
Pipeline embolization devices (PEDs) have been increasingly used for the treatment of posterior circulation aneurysms.
To investigate the safety and efficacy of PED in the treatment of small to medium unruptured vertebral artery intracranial aneurysms (VAIAs).
Data from 76 patients with 78 unruptured small and medium (≤12 mm) VAIAs were analyzed. Data for this study come from the PLUS study, which was conducted at 14 centers in China from 2014 to 2019. Univariate analyses were performed to evaluate predictors of the occlusion and complication.
Seventy-eight aneurysms in 76 patients were treated with PED. The mean aneurysm size was 8.28 ± 2.13 mm, and all PEDs were successfully placed. The median follow-up was 7 months and available for 67 (85.9%) aneurysms. Complete occlusion was seen in 60 (89.6%) aneurysms, which 86.6% met the primary efficacy outcome. All patients received clinical follow-up, the combined major morbidity and mortality was 2.6%, and 98.7% of patients had a good prognosis. Ischemic stroke occurred in 10.5% of patients, and adjuvant coil and successful after adjustment were predictors of ischemic stroke in the early postoperative and follow-up, respectively. There was no significant difference in the occlusion rate of aneurysm involving posterior inferior cerebellar artery ( P = .78). In cases where posterior inferior cerebellar artery was covered by PED, there was no significant difference in ischemic stroke.
In the treatment of unruptured ≤12 mm VAIAs, PED has a high surgical success rate, a high degree of occlusion, and low morbidity and mortality. PED may be a promising endovascular technique.
Pipeline 栓塞装置（PED）已越来越多地用于治疗后循环动脉瘤。
研究 PED 治疗小至中等未破裂椎动脉颅内动脉瘤（VAIAs）的安全性和有效性。
分析了 76 例 78 个未破裂小至中等（≤12mm）VAIAs 的患者数据。本研究数据来自 PLUS 研究，该研究于 2014 年至 2019 年在中国的 14 个中心进行。采用单变量分析评估闭塞和并发症的预测因素。
76 例患者的 78 个动脉瘤采用 PED 治疗。平均动脉瘤大小为 8.28±2.13mm，所有 PED 均成功放置。中位随访时间为 7 个月，67 个（85.9%）动脉瘤可获得随访。60 个（89.6%）动脉瘤完全闭塞，符合主要疗效终点的 86.6%。所有患者均接受临床随访，总的主要发病率和死亡率为 2.6%，98.7%的患者预后良好。10.5%的患者发生缺血性卒中，术后早期和随访中辅助线圈和调整后成功是缺血性卒中的预测因素。后下小脑动脉（PICA）受累动脉瘤的闭塞率无显著差异（P=0.78）。PED 覆盖 PICA 时，缺血性卒中无显著差异。
在治疗未破裂的≤12mm VAIAs 时，PED 具有较高的手术成功率、较高的闭塞程度和较低的发病率和死亡率。PED 可能是一种很有前途的血管内技术。
