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Eclipse 双腔球囊导管栓塞治疗颅脑血管畸形的初步经验。

Initial Experience with the Eclipse Double-Lumen Balloon Catheter for Embolization of Cranial Vascular Malformations.

机构信息

Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

出版信息

World Neurosurg. 2024 Sep;189:e1083-e1091. doi: 10.1016/j.wneu.2024.07.089. Epub 2024 Jul 19.

DOI:10.1016/j.wneu.2024.07.089
PMID:39032640
Abstract

BACKGROUND

Double lumen balloon catheters (DLBCs) have emerged as a potential alternative to single lumen balloon catheters for endovascular embolization of arteriovenous malformations (AVMs) and dural arteriovenous fistulas (dAVFs). This study describes our preliminary experience with the Eclipse 2L DLBC in treating AVMs and dAVFs.

METHODS

Patients who underwent embolization of cranial dAVFs or AVMs at our institution from August 2021 to March 2024 were included. Spinal vascular malformations were excluded. Descriptive statistics were used to analyze procedural outcomes, technical nuances, and postoperative outcomes on follow-up.

RESULTS

Twenty-five patients who underwent 38 embolization procedures (15 AVMs and 23 dAVFs) met criteria for inclusion in this study. The mean age of the cohort was 52.44 (standard deviation = 17.26), and 48% of the overall cohort (n = 13) was female. The average procedure times for AVMs and dAVFs were 80.4 minutes and 96.73 minutes, respectively. There was 1 instance of catheter entrapment. Two patients in the AVM cohort experienced mortality, and 1 experienced postoperative rupture.

CONCLUSIONS

Our preliminary experience using the Eclipse 2L balloon catheter for Onyx embolization reported procedural outcomes comparable to other DLBCs despite relatively higher procedure times and radiation doses. Further long-term studies on its efficacy as primary modality in treating AVMs and dAVFs are encouraged.

摘要

背景

双腔球囊导管(DLBC)已成为血管内动静脉畸形(AVMs)和硬脑膜动静脉瘘(dAVFs)栓塞的潜在替代方法,优于单腔球囊导管。本研究描述了我们使用 Eclipse 2L DLBC 治疗 AVMs 和 dAVFs 的初步经验。

方法

我们机构于 2021 年 8 月至 2024 年 3 月对颅 dAVFs 或 AVMs 进行栓塞的患者符合纳入本研究的标准。排除脊髓血管畸形。使用描述性统计分析来分析手术结果、技术细节和术后随访结果。

结果

25 名患者接受了 38 次栓塞治疗(15 例 AVM 和 23 例 dAVFs),符合本研究的纳入标准。该队列的平均年龄为 52.44 岁(标准差=17.26),总队列的 48%(n=13)为女性。AVM 和 dAVF 的平均手术时间分别为 80.4 分钟和 96.73 分钟。有 1 例导管嵌顿。AVM 组中有 2 例患者死亡,1 例患者术后破裂。

结论

尽管手术时间和辐射剂量相对较高,但我们使用 Eclipse 2L 球囊导管进行 Onyx 栓塞的初步经验报告的手术结果与其他 DLBC 相当。鼓励进一步开展关于其作为治疗 AVMs 和 dAVFs 的主要治疗方法的长期研究。

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