Krug Nadja, Kirschke Jan S, Maegerlein Christian, Kreiser Kornelia, Wostrack Maria, Meyer Bernhard, Albrecht Carolin, Zimmer Claus, Boeckh-Behrens Tobias, Sepp Dominik
Department of Neuroradiology, University Hospital Heidelberg, 69120 Heidelberg, Germany.
Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany.
Brain Sci. 2025 Jan 3;15(1):42. doi: 10.3390/brainsci15010042.
The p48 MW HPC is a novel low-profile flow diverter covered by a hydrophilic polymer coating with antithrombogenic properties, which may reduce ischemic complications and enable a single antiplatelet therapy after insertion of the stent. In this single-center experience, we describe the efficacy of this device, focusing on the illustration of different therapeutic indications and the outcome in various clinical settings with regard to vessel anatomy, bleeding state, and aneurysm configuration. We retrospectively reviewed our database for all patients being treated with a p48 MW HPC flow diverter between February 2019 and July 2021. The efficacy of the treatment was evaluated according to the O'Kelly-Marotta (OKM) scale in the last digital subtraction angiography (DSA) follow-up. Information on complications and medications were collected from our medical records. In addition, to illustrate different indications and clinical settings, we present six of these cases in closer detail. 18 aneurysms in 14 patients were treated with the p48 MW HPC flow diverter and in one case with an additional Derivo device. Periprocedural events occurred in 28.6% of the treated patients, which were all successfully resolved within the same session. Follow-up examination information was available for 67% of patients, of which 75% showed complete occlusion of the aneurysm and 83.3% showed a favorable occlusion result (OKM C-D). Two patients with ruptured aneurysms received a single antiplatelet therapy with ASA without thrombotic complications, at least in the short term. New braid deformation patterns were observed in 16.6% at the follow-up examination, but none with subsequent clinical significance. The p48 MW HPC is safe and effective in the treatment of a wide spectrum of differently configurated, ruptured, and unruptured aneurysms. Single antiplatelet therapy might be an option in selected cases.
p48 MW HPC是一种新型的低轮廓血流分流器，表面覆盖有具有抗血栓形成特性的亲水性聚合物涂层，这可能会减少缺血性并发症，并使得在支架植入后能够采用单一抗血小板治疗。在这项单中心经验中，我们描述了该装置的疗效，重点阐述了不同的治疗适应症以及在血管解剖结构、出血状态和动脉瘤形态各异的各种临床情况下的治疗结果。我们回顾性分析了2019年2月至2021年7月期间所有接受p48 MW HPC血流分流器治疗患者的数据库。根据最后一次数字减影血管造影（DSA）随访中的奥凯利 - 马罗塔（OKM）量表评估治疗效果。从我们的病历中收集并发症和用药信息。此外，为了说明不同的适应症和临床情况，我们更详细地介绍其中6例病例。14例患者的18个动脉瘤接受了p48 MW HPC血流分流器治疗，1例患者还额外使用了Derivo装置。28.6%的接受治疗患者发生了围手术期事件，均在同一手术过程中成功解决。67%的患者有随访检查信息，其中75%的患者动脉瘤完全闭塞，83.3%的患者显示出良好的闭塞结果（OKM C - D）。两名动脉瘤破裂患者接受了阿司匹林单一抗血小板治疗，至少在短期内没有血栓形成并发症。随访检查中观察到16.6%的患者出现新的编织物变形模式，但均无后续临床意义。p48 MW HPC在治疗各种形态各异、破裂和未破裂的动脉瘤方面安全有效。在某些选定病例中，单一抗血小板治疗可能是一种选择。
