Department of Neurosurgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China.
Jiangxi Key Laboratory of Neurological Tumors and Cerebrovascular Diseases, Nanchang, 330006, Jiangxi, China.
Neurosurg Rev. 2024 Sep 7;47(1):560. doi: 10.1007/s10143-024-02756-8.
The role of a low-profile visualized intraluminal support stent (LVIS) and Enterprise in the treatment of unruptured intracranial aneurysms is well established. Although previous studies have investigated one single type of stent for the treatment of ruptured intracranial aneurysms (RIA), the safety and efficacy between the two types of stents has not been fully explored. Herein we conducted a study to compare the outcomes of the two stents for treatment of RIA. This is a prospective registry database of aneurysmal subarachnoid hemorrhage (aSAH) patients admitted to a single institution between 2018 and 2021. We collected patient baseline information, secondary complications, follow-up angiographic data, long-term prognostic outcomes, and conducted propensity score matching (PSM) analysis with 1:1 ratio and a multivariable logistic regression to compare the outcomes of the two types of stents. A total of 231 patients with RIAs were included in this study, with 108 treated using the LVIS device and 123 treated using the Enterprise device. Before PSM analysis, only the incidence of poor prognosis after 12 months was higher in the Enterprise group comparing to the LVIS group (20% vs. 10%, P = 0.049). After PSM analysis, there was a higher occurrence of delayed cerebral ischemia (DCI) in the Enterprise group compared to the LVIS group (odds ratio [OR] 3.95, 95% confidence interval [CI] [1.20-13.01], P = 0.024). However, no significant difference in prognosis was observed after PSM adjustment. Furthermore, subgroup analysis revealed that patients with female (P = 0.019), hypertension (P = 0.048), and anterior circulation aneurysms (P = 0.019) receiving the Enterprise device had a higher risk of DCI. The overall efficacy of LVIS and Enterprise in the treatment of RIA is comparable, while the incidence of DCI in the LVIS group is lower than that in the Enterprise group after PSM analysis. Registration number: NCT05738083 ( https://clinicaltrials.gov/ ).
经皮血管内介入治疗颅内未破裂动脉瘤中，低轮廓可视化腔内支撑支架（LVIS）和 Enterprise 支架的作用已得到充分证实。尽管先前的研究已经调查了单一类型的支架治疗破裂颅内动脉瘤（RIA），但两种支架之间的安全性和疗效尚未得到充分探索。在此，我们进行了一项研究，比较了两种支架治疗 RIA 的结果。这是一项针对 2018 年至 2021 年期间在单一机构住院的蛛网膜下腔出血（aSAH）患者的前瞻性登记数据库研究。我们收集了患者的基线信息、二级并发症、随访血管造影数据、长期预后结果，并进行了 1:1 比例的倾向评分匹配（PSM）分析和多变量逻辑回归，以比较两种类型支架的结果。本研究共纳入 231 例 RIA 患者，其中 108 例采用 LVIS 装置治疗，123 例采用 Enterprise 装置治疗。在 PSM 分析之前，Enterprise 组的预后不良发生率高于 LVIS 组（20%比 10%，P=0.049）。PSM 分析后，Enterprise 组较 LVIS 组发生迟发性脑缺血（DCI）的概率更高（比值比[OR] 3.95，95%置信区间[CI] [1.20-13.01]，P=0.024）。然而，PSM 调整后预后无显著差异。此外，亚组分析显示，女性（P=0.019）、高血压（P=0.048）和前循环动脉瘤（P=0.019）患者接受 Enterprise 装置治疗时发生 DCI 的风险更高。LVIS 和 Enterprise 在治疗 RIA 中的总体疗效相当，而 PSM 分析后 LVIS 组 DCI 的发生率低于 Enterprise 组。注册号：NCT05738083（ https://clinicaltrials.gov/ ）。
