Wu Qiaowei, Meng Yuxiao, Chen Aixia, Xu Shancai, Wang Chunlei, Ji Zhiyong, Qi Jingtao, Yuan Kaikun, Shao Jiang, Shi Huaizhang, Wu Pei
Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Front Neurol. 2023 Mar 24;14:1069380. doi: 10.3389/fneur.2023.1069380. eCollection 2023.
This study aimed to evaluate the feasibility of the low-profile visualized intraluminal support (LVIS)-within-enterprise double-stent technique for patients with acutely ruptured intracranial vertebrobasilar artery-dissecting aneurysms (ari-VBDAs).
A total of 30 patients with ari-VBDAs who underwent reconstructive treatment using LVIS-within-enterprise double-stent technique with coil embolization between January 2014 and May 2022 were retrospectively enrolled. Patients' characteristics and clinical and imaging outcomes were reviewed. The functional outcomes were assessed using the modified Rankin scale (mRS).
A total of 34 ari-VBDAs were identified, including seven (20.6%) basilar artery aneurysms and 27 (79.4%) vertebral artery aneurysms. All aneurysms were successfully treated in the acute phase. In total, six (20.0%) patients experienced in-hospital serious adverse events, including two deaths (6.7%). The median clinical follow-up time of the remaining 28 patients was 20.0 (IQR, 7.3-40.8) months. The incidences of dependency or death (mRS score of 3-6) at discharge and at the last follow-up were 16.7% and 14.3%, respectively. Aneurysm rebleeding occurred in one (3.3%) patient periprocedurally. In total, three (10.0%) patients had ischemic events, one of which occurred during the periprocedural period and two occurred during follow-up. A total of two patients (6.7%) underwent ventriculoperitoneal shunt. Imaging follow-up was available for 14 patients at the median of 12.0 (IQR, 7.0-12.3) months, with a complete occlusion rate of 93.3% (14/15). In total, one patient experienced parent artery occlusion, and no aneurysm was recanalized.
LVIS-within-enterprise double-stent technique with coil embolization for the treatment of patients with ari-VBDAs could be performed with a good safety profile and high technical success rate. The rate of complete aneurysm occlusion during follow-up seemed to be satisfactory.
本研究旨在评估企业内低轮廓可视化腔内支撑（LVIS）双支架技术治疗急性破裂颅内椎动脉夹层动脉瘤（ari-VBDAs）患者的可行性。
回顾性纳入2014年1月至2022年5月期间30例采用企业内LVIS双支架技术联合弹簧圈栓塞进行重建治疗的ari-VBDAs患者。回顾患者的特征以及临床和影像学结果。使用改良Rankin量表（mRS）评估功能结局。
共识别出34个ari-VBDAs，包括7个（20.6%）基底动脉动脉瘤和27个（79.4%）椎动脉动脉瘤。所有动脉瘤均在急性期成功治疗。共有6例（20.0%）患者发生院内严重不良事件，包括2例死亡（6.7%）。其余28例患者的中位临床随访时间为20.0（四分位间距，7.3 - 40.8）个月。出院时和末次随访时依赖或死亡（mRS评分为3 - 6）的发生率分别为16.7%和14.3%。围手术期有1例（3.3%）患者发生动脉瘤再出血。共有3例（10.0%）患者发生缺血性事件，其中1例发生在围手术期，2例发生在随访期间。共有2例（6.7%）患者接受了脑室腹腔分流术。14例患者在中位时间12.0（四分位间距，7.0 - 12.3）个月时进行了影像学随访，完全闭塞率为93.3%（14/15）。共有1例患者发生载瘤动脉闭塞，无动脉瘤再通。
企业内LVIS双支架技术联合弹簧圈栓塞治疗ari-VBDAs患者安全性良好，技术成功率高。随访期间动脉瘤完全闭塞率似乎令人满意。
