Khanafer Ali, Henkes Hans, Cohen Jose, Albiña-Palmarola Pablo, Gomori John Moshe, Forsting Michael, von Gottberg Philipp
Neuroradiologische Klinik, Klinikum Stuttgart, Stuttgart, Germany.
Medizinische Fakultät, Universität Duisburg-Essen, Essen, Germany.
Front Neurol. 2024 Mar 11;15:1368612. doi: 10.3389/fneur.2024.1368612. eCollection 2024.
Flow-diverter (FD) stents have become an established treatment for intracranial aneurysms in recent years, but their use for aneurysms in distal cerebral vessels with small carrier vessel diameters remains controversial. This study describes the method and mid- and long-term outcomes of FD treatment of distal anterior cerebral artery aneurysms (DACAAs) at two neurointerventional centers, to elucidate this topic and provide more in-depth data.
Data for all patients at two neurointerventional centers who were treated with FDs for DACAAs in the pericallosal and supracallosal segment of the anterior cerebral artery were retrospectively analyzed. Data on periprocedural complications, and short-, mid- and long-term follow-up findings were recorded.
Forty-one patients were eligible for inclusion in the study. Three FD models were used, one of which had an anti-thrombotic coating. Two periprocedural complications (5%) occurred but did not cause a change in the mRS. In the long-term follow-up, at 29 months and beyond, 83% of assessable patients showed complete occlusion of the aneurysms without new neurological deficits.
FDs are a safe and effective treatment approach for DACAAs. This study indicated a low risk of complications, and high closure rates in short-, mid- and long-term follow-up.
近年来，血流导向（FD）支架已成为颅内动脉瘤的既定治疗方法，但其用于载瘤血管直径较小的大脑远端血管动脉瘤的治疗仍存在争议。本研究描述了两个神经介入中心对大脑前动脉远端动脉瘤（DACAAs）进行FD治疗的方法及中长期结果，以阐明该主题并提供更深入的数据。
回顾性分析两个神经介入中心所有接受FD治疗大脑前动脉胼周段和胼胝体上段DACAAs患者的数据。记录围手术期并发症及短期、中期和长期随访结果。
41例患者符合纳入研究标准。使用了三种FD模型，其中一种带有抗血栓涂层。发生了2例围手术期并发症（5%），但未导致改良Rankin量表（mRS）评分改变。在长期随访中，29个月及以后，83%可评估患者的动脉瘤完全闭塞，且无新的神经功能缺损。
FD是治疗DACAAs的一种安全有效的方法。本研究表明并发症风险低，短期、中期和长期随访的闭塞率高。
