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采用屏蔽技术的新型管道优势血流导向分流支架的疗效和性能:单中心经验的短期结果

Efficacy and performance of the new pipeline vantage flow diverter stent with shield technology: Short-term results of a single-center experience.

作者信息

Çelebioğlu Emre Can, Blevrakis Emmanouil, Yilmaz Mehmet, Doğan İhsan, Erkent Fatmanur Duruk, Kortun Şeyda, Büyükceran Emre Utkan, Bayatlı Eyüp, Zaimoğlu Murat, Tuna Hakan, Ünlü Mustafa Ağahan, Bilgiç Sadık

机构信息

Department of Radiology/Vascular Interventional Radiology, Ankara University Faculty of Medicine, Ankara, Turkey.

Department of Radiology, NHS United Lincolnshire Hospitals Pilgrim Hospital, Boston, UK.

出版信息

Sci Prog. 2025 Apr-Jun;108(2):368504251349714. doi: 10.1177/00368504251349714. Epub 2025 Jun 10.

DOI:10.1177/00368504251349714
PMID:40495491
Abstract

ObjectivesThe aim of this study is to investigate and delineate the reliability and efficacy of the new Pipeline Vantage (PV). The flow diverter device was recently introduced presenting the innovative shield technology.MethodsThis retrospective study included 21 patients with 22 unruptured intracranial aneurysms, all of whom were treated with the PV device at our institution between January 2022 and January 2023. Patient demographics, aneurysm morphology and location, periprocedural strategies, treatment approaches, and occlusion status at follow-up (up to one year) were retrospectively analyzed.ResultsNineteen of the aneurysms (86.36%) were treated solely with the PV device and three (13.63%) were treated in combination with coil embolization. Two patients (9.52%) were expired, one related to a subarachnoid hemorrhage occurred during treatment and the second one after a successful treatment on follow-up, due to the existence of concomitant disease, not related to the aneurysm itself. The mean time of follow-up on the treated aneurysms was 7.4 months. In 81.81% (18 aneurysms) of the cases presented, a complete aneurysm obliteration was achieved on the last follow-up imaging.ConclusionsIn this initial experience, the PV flow diverter demonstrated favorable short- and mid-term outcomes in the treatment of intracranial aneurysms. While the overall complication profile was acceptable, the occurrence of a periprocedural mortality reflects the inherent procedural risks of neurointervention, even under meticulous technique. However, short-term results should be balanced with caution and supported by robust research to demonstrate the long-term safety and efficacy of the device.Advances in knowledgePV the successor of the novel Pipeline device showed promising short-term results.

摘要

目的

本研究旨在调查并描述新型Pipeline Vantage(PV)的可靠性和有效性。这种血流导向装置最近被引入,具有创新的屏蔽技术。

方法

这项回顾性研究纳入了21例患有22个未破裂颅内动脉瘤的患者,所有患者均于2022年1月至2023年1月在我院接受了PV装置治疗。回顾性分析了患者的人口统计学资料、动脉瘤形态和位置、围手术期策略、治疗方法以及随访(最长一年)时的闭塞情况。

结果

19个动脉瘤(86.36%)仅接受了PV装置治疗,3个(13.63%)接受了联合弹簧圈栓塞治疗。2例患者(9.52%)死亡,1例与治疗期间发生的蛛网膜下腔出血有关,另1例在随访时成功治疗后死亡,原因是存在合并症,与动脉瘤本身无关。治疗的动脉瘤的平均随访时间为7.4个月。在81.81%(18个动脉瘤)的病例中,在最后一次随访影像学检查时实现了动脉瘤的完全闭塞。

结论

在这一初步经验中,PV血流导向装置在颅内动脉瘤治疗中显示出良好的短期和中期结果。虽然总体并发症情况可以接受,但围手术期死亡率的发生反映了神经介入手术固有的风险,即使在技术精细的情况下也是如此。然而,短期结果应谨慎权衡,并需要强有力的研究支持以证明该装置的长期安全性和有效性。

知识进展

新型Pipeline装置的后继产品PV显示出有希望的短期结果。

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本文引用的文献

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Vanguard Study: Initial experience with the new fourth generation Pipeline Vantage Flow Diverter (PVFD): 6-month results, technical and clinical considerations.先锋研究:新型第四代Pipeline Vantage血流导向装置(PVFD)的初步经验:6个月结果、技术及临床考量
J Neurointerv Surg. 2024 Dec 26;17(e1):e166-e171. doi: 10.1136/jnis-2023-021182.
2
Early clinical experience with the new generation Pipeline Vantage flow diverter in the treatment of unruptured saccular aneurysms using short-term dual antiplatelet therapy.新一代Pipeline Vantage血流导向装置采用短期双联抗血小板治疗未破裂囊状动脉瘤的早期临床经验。
Interv Neuroradiol. 2023 Oct 5:15910199231205047. doi: 10.1177/15910199231205047.
3
Early Outcomes of the Pipeline Vantage Flow Diverter : A Multicentre Study.
Pipeline Vantage 血流导向装置的早期结果:一项多中心研究。
Clin Neuroradiol. 2023 Dec;33(4):887-896. doi: 10.1007/s00062-023-01314-x. Epub 2023 Jun 28.
4
The first decade of flow diversion for intracranial aneurysms with the Pipeline embolization device.使用Pipeline栓塞装置进行颅内动脉瘤血流导向治疗的首个十年。
Neurosurg Focus. 2023 May;54(5):E2. doi: 10.3171/2023.2.FOCUS22646.
5
Telescoping pipeline vantage embolization devices with shield technology for the treatment of a giant, symptomatic dolichoectatic basilar trunk aneurysm.采用带屏蔽技术的可伸缩管道优势栓塞装置治疗巨大、有症状的长梭形基底动脉干动脉瘤。
Surg Neurol Int. 2022 Sep 23;13:434. doi: 10.25259/SNI_701_2022. eCollection 2022.
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The 8-year single-center experience of telescoping flow diverter for complex intracranial aneurysms treatment.8 年单中心应用伸缩血流导向装置治疗颅内复杂动脉瘤的经验。
J Clin Neurosci. 2022 Jun;100:131-137. doi: 10.1016/j.jocn.2022.04.014. Epub 2022 Apr 19.
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