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血流导向支架在颅外颈动脉动脉瘤治疗中的应用

Flow-diverting stents in the management of extracranial carotid artery aneurysms.

作者信息

Cinar Celal, Akgul Erol, Elek Alperen, Kusbeci Mahmut, Ozturk Egemen, Onan Hasan Bilen, Islek Irem, Forogh Mohammad Naim, Nasiri Mohammad Nawas, Oran Ismail

机构信息

Ege University Faculty of Medicine, Department of Interventional Radiology, İzmir, Türkiye.

İstanbul Medipol University Faculty of Medicine, Department of Radiology, İstanbul, Türkiye.

出版信息

Diagn Interv Radiol. 2025 Sep 8;31(5):489-495. doi: 10.4274/dir.2024.242946. Epub 2024 Dec 30.

Abstract

PURPOSE

This study aims to investigate the indications and therapeutic efficacy of flow-diverting stents (FDSs) in the management of extracranial carotid artery aneurysms (ECAAs) and dissections.

METHODS

A retrospective analysis was conducted on 18 patients treated for ECAAs with an FDS between 2010 and 2024. Patient demographics, aneurysm characteristics, procedural details, and clinical and radiologic follow-up outcomes were extracted from medical records. Procedures were performed under general anesthesia using standard endovascular techniques. Patients received preoperative and postoperative antiplatelet therapy and were fully anticoagulated during the procedure. Follow- up assessments included digital subtraction angiography or computed tomography angiography at 6-12 months and clinical evaluations to monitor symptom resolution and complications.

RESULTS

Eighteen patients, with an average age of 46.44 ± 17.54 years, underwent 19 endovascular interventions. Technical success was achieved in all cases. Single stent deployment was used in 15 aneurysms, and telescopic stent deployment in 7. Total occlusion of the aneurysm was achieved in 94.4% of cases. One patient required retreatment due to the separation of two overlapped telescopic stents. All patients were discharged within 2 days post-procedure, with symptomatic patients experiencing the complete resolution of symptoms. No complications or adverse events were reported during the follow-up period.

CONCLUSION

The endovascular treatment of ECAAs with FDSs appears to be a safe and effective alternative, achieving high technical success and positive clinical outcomes.

CLINICAL SIGNIFICANCE

The use of FDSs for treating ECAAs significantly improves patient outcomes with minimal complications.

摘要

目的

本研究旨在探讨血流导向支架(FDS)在颅外颈动脉动脉瘤(ECAA)和夹层治疗中的适应证及治疗效果。

方法

对2010年至2024年间18例接受FDS治疗ECAA的患者进行回顾性分析。从病历中提取患者人口统计学信息、动脉瘤特征、手术细节以及临床和影像学随访结果。手术在全身麻醉下采用标准血管内技术进行。患者术前和术后接受抗血小板治疗,术中充分抗凝。随访评估包括6至12个月时的数字减影血管造影或计算机断层扫描血管造影以及临床评估,以监测症状缓解情况和并发症。

结果

18例患者,平均年龄46.44±17.54岁,接受了19次血管内介入治疗。所有病例均取得技术成功。15个动脉瘤采用单支架置入,7个采用重叠支架置入。94.4%的病例实现了动脉瘤完全闭塞。1例患者因两个重叠的可伸缩支架分离需要再次治疗。所有患者术后2天内出院,有症状的患者症状完全缓解。随访期间未报告并发症或不良事件。

结论

采用FDS对ECAA进行血管内治疗似乎是一种安全有效的替代方法,取得了较高的技术成功率和良好的临床效果。

临床意义

使用FDS治疗ECAA可显著改善患者预后,并发症极少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/972c/12417920/2b6cb69d1bc1/DiagnIntervRadiol-31-5-489-figure-1.jpg

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