Balci Sinan, Çay Ferdi, Uysal Aycan, Arat Anil
Department of Radiology, Hacettepe University, 06230 Ankara, Turkey.
Department of Neurosurgery, Yale University, New Haven, CT 06510, USA.
Brain Sci. 2024 Sep 10;14(9):911. doi: 10.3390/brainsci14090911.
The aim of this study is to present the outcomes of cerebral aneurysm treatment with the DERIVO mini Embolisation Device (DMD), which is compatible with microcatheters with 0.021-inch inner diameters. Consecutive patients treated with DMD were identified retrospectively. Patient and aneurysm characteristics, procedural findings, clinical outcomes and follow-up imaging results were evaluated. A total of 44 target aneurysms in 30 patients were treated with DMD. The mean age of the patients was 49.9 (range, 4-77 years). Four patients with five aneurysms presented with acute subarachnoid hemorrhage. The mean aneurysm size was 6.8 mm (range, 1.5-22 mm). In 29 (65.9%) aneurysms, adjunctive devices were used for endovascular treatment. The overall mortality rate was 3.3% and procedure-related mortality was 0%. Overall neurologic morbidity was 6.6% and none of the patients had a permanent sequela secondary to the procedure. The mean clinical follow-up period was 20.9 months (range, 3 days-46 months) and the mean DSA follow-up period was 10.9 months. A total of 37 (84.1%) aneurysms demonstrated total occlusion (Raymond-Roy [RR 1]); 3 (6.8%) aneurysms had a neck remnant or infundibular filling at the origin of the jailed side branch (RR 2), 4 (9.1%) aneurysms had residual aneurysm filling (RR 3). For those aneurysms treated with bare DMD, the total occlusion rate was 73.3% at a mean follow-up of 16.1 months. In this initial clinical single-center experience, DMD had a good safety profile and efficacy comparable with the currently used flow diverters.
本研究的目的是呈现使用内径为0.021英寸的微导管兼容的DERIVO微型栓塞装置(DMD)治疗脑动脉瘤的结果。对接受DMD治疗的连续患者进行回顾性识别。评估患者和动脉瘤的特征、手术结果、临床结局以及随访影像结果。30例患者共44个目标动脉瘤接受了DMD治疗。患者的平均年龄为49.9岁(范围4至77岁)。4例患者的5个动脉瘤表现为急性蛛网膜下腔出血。动脉瘤平均大小为6.8毫米(范围1.5至22毫米)。在29个(65.9%)动脉瘤中,辅助装置用于血管内治疗。总死亡率为3.3%,与手术相关的死亡率为0%。总体神经功能障碍发生率为6.6%,且无患者因手术出现永久性后遗症。平均临床随访期为20.9个月(范围3天至46个月),平均数字减影血管造影(DSA)随访期为10.9个月。共有37个(84.1%)动脉瘤显示完全闭塞(Raymond-Roy [RR 1]);3个(6.8%)动脉瘤在被栓塞侧支血管起始处有颈部残留或漏斗状充盈(RR 2),4个(9.1%)动脉瘤有动脉瘤残余充盈(RR 3)。对于那些仅使用DMD治疗的动脉瘤,在平均16.1个月的随访中,完全闭塞率为73.3%。在这项初步的临床单中心经验中,DMD具有良好的安全性,其疗效与目前使用的血流导向装置相当。