使用 Tubridge 血流导向装置治疗颅内动脉瘤：单中心经验。
Use of the Tubridge flow diverter in the treatment of intracranial aneurysms: a single center experience.
机构信息
Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, Henan Province, China.
出版信息
Sci Rep. 2024 Mar 27;14(1):7255. doi: 10.1038/s41598-024-57840-2.
To investigate the safety and effect of Tubridge flow diverter deployment for the treatment of intracranial aneurysms, 85 patients with intracranial aneurysms treated with the Tubridge flow diverter were retrospectively enrolled. The clinical data including the baseline data, aneurysm parameters before and after treatment, and follow-up outcomes were assessed. Among 85 patients, there were 35 (41.2%) males and 50 females (58.8%) aged 17-77 (mean 56.7 ± 11.1) years with 110 aneurysms. Five (5.9%) patients initially presented with subarachnoid hemorrhage from aneurysm rupture. The aneurysm size was 2-30 (mean 8.6) mm, and the aneurysm neck was 2-10.6 (mean 5.7 ± 2.3) mm. Ninety-three Tubridge stents were deployed. Twenty-five (29.4%) patients experienced adjunctive loose coiling. Blood flow was significantly reduced from entering the aneurysm after stent deployment. Periprocedural complications occurred in three (3.5%) patients, including in-stent thrombosis during embolization in one patient (1.2%), conjunctiva edema on the right in one patient (1.2%), and acute multiple cerebral infarctions in one patient (1.2%). Angiographic follow-up was conducted in 67 (78.8%) patients 3-36 (mean 15.3 ± 5.6) months later. In 11 (16.4% or 11/67) patients, blood flow still entered the aneurysm with the O'Kelly-Marotta (OKM) grade B in two (3.0%) patients and grade C in nine (13.4%), whereas complete occlusion (OKM grade D) was achieved in the other 56 (83.6% or 56/67) aneurysms. In-stent stenosis was present in five (7.5%) patients with approximately 25% stenosis in three (4.5%) patients and 50% in two (3.0%). In conclusion, the Tubridge flow diverter can be safely and efficiently applied in the treatment of small and large intracranial aneurysms, with a low periprocedural complication rate, a high occlusion degree, and a low in-stent stenosis rate at follow-up even though large aneurysms may necessitate a longer surgical time and adjunctive coiling.
为了研究 Tubridge 血流导向装置治疗颅内动脉瘤的安全性和效果，回顾性纳入了 85 例颅内动脉瘤患者，这些患者均采用 Tubridge 血流导向装置进行治疗。评估了包括基线数据、治疗前后的动脉瘤参数以及随访结果在内的临床数据。85 例患者中，男性 35 例（41.2%），女性 50 例（58.8%），年龄 17-77 岁，平均 56.7±11.1 岁。有 110 个动脉瘤，其中 5 例（5.9%）患者最初因动脉瘤破裂出现蛛网膜下腔出血。动脉瘤大小为 2-30mm（平均 8.6mm），瘤颈大小为 2-10.6mm（平均 5.7±2.3mm）。共植入 93 枚 Tubridge 支架。25 例（29.4%）患者行辅助性疏松弹簧圈栓塞。支架植入后，瘤内血流明显减少。3 例（3.5%）患者发生围手术期并发症，包括 1 例（1.2%）患者在栓塞过程中发生支架内血栓形成、1 例（1.2%）患者右侧球结膜水肿和 1 例（1.2%）患者急性多发性脑梗死。67 例（78.8%）患者在术后 3-36 个月（平均 15.3±5.6 个月）进行了血管造影随访。11 例（16.4%，11/67）患者的动脉瘤仍有血流进入，其中 2 例（3.0%）患者 OKM 分级为 B 级，9 例（13.4%）患者为 C 级，而其余 56 例（83.6%，56/67）患者完全闭塞（OKM 分级 D 级）。5 例（7.5%）患者支架内狭窄，其中 3 例（4.5%）狭窄约 25%，2 例（3.0%）狭窄约 50%。总之，Tubridge 血流导向装置可安全有效地应用于小、大型颅内动脉瘤的治疗，围手术期并发症发生率低，闭塞程度高，随访时支架内狭窄率低，尽管大型动脉瘤可能需要更长的手术时间和辅助弹簧圈栓塞。
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