Ankara Bilkent City Hospital, Department of Interventional Neuroradiology, Ankara, Turkey.
Turk Neurosurg. 2023;33(3):477-487. doi: 10.5137/1019-5149.JTN.42071-22.1.
To report our experience with the 2.5-mm Surpass EvolveTM flow diverter (FD) in the treatment of distal small cerebral artery aneurysms.
This study included 41 patients with 52 aneurysms. Clinical and radiological records and procedural and follow-up outcomes were reviewed retrospectively.
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.
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.
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。
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。
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)。
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。