Lu Dan, Lei Hui, Fang Wei, Wang Naibing, Chen Hu, Luo Guoqiang, Zhao Zhenwei, Zhang Tao, Deng Jianping
Department of Neurosurgery, Xi'an International Medical Center Hospital, Xi'an, China.
Department of Neurology, Xi'an Central Hospital, Xi'an, China.
World Neurosurg. 2025 Mar;195:123568. doi: 10.1016/j.wneu.2024.123568. Epub 2025 Jan 11.
Currently, there is no established treatment consensus for craniocervical unruptured dissecting aneurysms (UDAs). This study aimed to assess the safety and efficacy of the Surpass Streamline Flow Diverter (SSFD) for treating craniocervical UDAs.
A retrospective review of 3 centers' databases was conducted to identify patients with craniocervical UDAs treated with SSFDs from January 2021 to December 2023. Data, including patient and aneurysm characteristics, procedure details, imaging findings, and follow-up data were analyzed.
The study included 35 patients with 35 craniocervical UDAs. The mean maximal length of the UDAs was 13.0 ± 6.0 mm, with 57% ranging from 10 to 25 mm. At a mean follow-up of 8.7 ± 2.5 months, the complete occlusion rate was 71% (25/35), with no recurrences detected. Perioperative complications occurred in 3 patients (9%), comprising ischemic stroke in 2 patients (6%) and hemorrhagic stroke in 1 patient (3%). All patients had a good clinical outcome at the 6-month follow-up (modified Rankin Scale <3). Multivariate logistic regression analysis revealed that aneurysmal dilation with stenosis (odds ratio = 0.034, 95% confidence interval: 0.001-0.845; P = 0.04) was a significant predictive factor for incomplete occlusion of treated aneurysms.
Our findings suggest that SSFD is a safe and effective tool for craniocervical UDAs, demonstrating a high occlusion rate, acceptable complication rate, and good clinical outcome.
目前，对于颅颈未破裂夹层动脉瘤（UDAs）尚无既定的治疗共识。本研究旨在评估Surpass Streamline血流导向装置（SSFD）治疗颅颈UDAs的安全性和有效性。
对3个中心的数据库进行回顾性分析，以确定2021年1月至2023年12月期间接受SSFD治疗的颅颈UDAs患者。分析患者和动脉瘤特征、手术细节、影像学检查结果及随访数据等资料。
本研究纳入35例患者的35个颅颈UDAs。UDAs的平均最大长度为13.0±6.0mm，其中57%的动脉瘤长度在10至25mm之间。平均随访8.7±2.5个月时，完全闭塞率为71%（25/35），未检测到复发。3例患者（9%）发生围手术期并发症，包括2例患者（6%）发生缺血性卒中，1例患者（3%）发生出血性卒中。所有患者在6个月随访时临床预后良好（改良Rankin量表评分<3）。多因素逻辑回归分析显示，伴有狭窄的动脉瘤扩张（比值比=0.034，95%置信区间：0.001-0.845；P=0.04）是治疗动脉瘤不完全闭塞的重要预测因素。
我们的研究结果表明，SSFD是治疗颅颈UDAs的一种安全有效的工具，具有高闭塞率、可接受的并发症发生率和良好的临床预后。
