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低剖面 Surpass Evolve 血流导向装置在远端大脑动脉动脉瘤血管内治疗中的评估:单中心经验。

The Evaluation of Low-Profile Surpass Evolve Flow Diverter for Endovascular Treatment of Distal Cerebral Artery Aneurysms: A Single-Center Experience.

机构信息

Ankara Bilkent City Hospital, Department of Interventional Neuroradiology, Ankara, Turkey.

出版信息

Turk Neurosurg. 2023;33(3):477-487. doi: 10.5137/1019-5149.JTN.42071-22.1.

Abstract

AIM

To report our experience with the 2.5-mm Surpass EvolveTM flow diverter (FD) in the treatment of distal small cerebral artery aneurysms.

MATERIAL AND METHODS

This study included 41 patients with 52 aneurysms. Clinical and radiological records and procedural and follow-up outcomes were reviewed retrospectively.

RESULTS

The aneurysm morphology was saccular in 45 patients, dissecting in five patients, and fusiform in two patients. Fifty-two aneurysms were treated with 41 Surpass Evolve FDs. The mean diameters of the proximal and distal parent arteries were 2.56 and 2.17 mm, respectively. The mean duration of follow-up was 16.2 ± 6.6 (6-28) months. Four (10%) patients had acute subarachnoid hemorrhage. In the same session, two patients with two tandem aneurysms and one patient with four tandem aneurysms were treated using a single FD. Intraprocedural hemorrhage and femoral artery pseudoaneurysm occurred in two patients during the procedure. Digital subtraction angiography was performed on 38/41 (92%) patients with 47/52 (88%) having aneurysms. Complete occlusion (OKM D) was observed in 39/47 (82%) aneurysms, and near complete-complete occlusion (OKM C-D) was observed in 46/47 (98%) aneurysms.

CONCLUSION

Endovascular treatment of distal cerebral artery aneurysms with the 2.5-mm Surpass Evolve < sup > TM < /sup > FD provides a high rate of aneurysm occlusion with low periprocedural complications, even in ruptured and tandem aneurysms.

摘要

目的

报告我们使用 2.5mm Surpass EvolveTM 血流导向装置(FD)治疗远端小脑血管动脉瘤的经验。

材料与方法

本研究纳入了 41 例 52 个动脉瘤患者。回顾性分析了临床和影像学资料、手术过程和随访结果。

结果

45 例患者的动脉瘤形态为囊状,5 例为夹层状,2 例为梭形。52 个动脉瘤采用 41 枚 Surpass Evolve FD 治疗。近端和远端载瘤动脉的平均直径分别为 2.56mm 和 2.17mm。平均随访时间为 16.2±6.6(6-28)个月。4(10%)例患者发生急性蛛网膜下腔出血。在同一治疗过程中,2 例患者的 2 个串联动脉瘤和 1 例患者的 4 个串联动脉瘤采用 1 枚 FD 治疗。2 例患者在治疗过程中发生术中出血和股动脉假性动脉瘤。41 例患者中的 38 例行数字减影血管造影术(DSA)检查,其中 47 个动脉瘤中有 47 个(88%)行 DSA 检查。39/47(82%)个动脉瘤完全闭塞(OKM D),46/47(98%)个动脉瘤接近完全闭塞(OKM C-D)。

结论

使用 2.5mm Surpass EvolveTM FD 治疗远端脑动脉动脉瘤,即使在破裂和串联动脉瘤中,也能获得较高的动脉瘤闭塞率和较低的围手术期并发症发生率。

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