用于治疗大脑前动脉远端动脉瘤的Silk Vista Baby
Silk Vista Baby for the treatment of distal anterior cerebral artery aneurysms.
作者信息
Scarcia Luca, Clarençon Frédéric, Dmytriw Adam A, Shotar Eimad, Jabbour Pascal, Psychogios Marios, Sporns Peter, Puri Ajit S, Hassan Ameer E, Algin Oktay, Möhlenbruch Markus A, Russo Riccardo, Bergui Mauro, Goren Oded, Bankole Nourou Dine A, Boulouis Gregoire, Morimoto Takeshi, Pop Raoul, Ho Joanna Wk, Ferrario Ángel, Pujol Lereis Virginia, Cooper Jared, Salsano Giancarlo, Li Yan-Lin, Consoli Arturo, Sgreccia Alessandro, Raz Eytan, Chung Charlotte, Burel Julien, Papagiannaki Chrysanthi, Baqir Hassan Khawaja Muhammad, Tao Hong, Rautio Riitta, Sinislao Matias, Ruggiero Maria, Lafe Elvis, Da Ros Valerio, Bellini Luigi, Gabrieli Joseph Domenico, Causin Francesco, Levitt Michael, Caragliano Antonio Armando, Vinci Sergio Lucio, Bellanger Guillaume, Cognard Christophe, Marnat Gaultier, Saleille Lisa, Nimbucci Nicola, Capasso Francesco, Piano Mariangela, Rollo Claudia, Guedon Alexis, Romi Andrea, Di Caterino Fortunato, Biondi Alessandra, Farhat Firas, Vyval Mykola, Guenego Adrien, Nguyen Thanh, Abdalkader Mohamad, Gunkan Ahmet, Agripnidis Thibault, Fuschi Maurizio, Pereira Vitor Mendes, Alexandre Andrea M, Pedicelli Alessandro
机构信息
Neuroradiology Unit, Henri Mondor Hospital, Creteil, France.
Department of Neuroradiology, Pitié-Salpêtrière Hospital, Sorbonne University, APHP, 47, Bd de l'Hôpital, 75013, Paris, France.
出版信息
Neuroradiology. 2025 Jul 2. doi: 10.1007/s00234-025-03678-y.
PURPOSE
Treating small-caliber vessel aneurysms with flow diverters poses challenges due to narrow luminal diameters and tortuous vasculature, which complicate the navigation and deployment of conventional devices using standard microcatheters. The Silk Vista Baby (SVB, Balt, Montmorency, France) flow diverter was developed to treat intracranial aneurysms located in smaller vessels or more distal segments and is compatible with 0.017″ microcatheters. We present the largest multicenter analysis to date evaluating the outcomes of SVB use in unruptured distal anterior cerebral artery (DACA) aneurysms.
METHODS
Retrospective data from 20 centers were reviewed for patients with unruptured DACA aneurysms treated with the SVB. Demographic information, clinical presentation, radiographic characteristics, complications, and outcomes were recorded.
RESULTS
Seventy-nine patients (79 DACA aneurysms) were treated between January 2018 and December 2022; 59 were female (74.7%), and the median age was 61 years (IQR 53-67). Most aneurysms were saccular (89.9%), and 65.8% involved a branch. The median parent vessel diameter was 1.9 mm (IQR 1.7-2.1). A single stent was implanted in 97.5% of cases; 2.5% required two stents. The median imaging follow-up duration was 12 months (IQR 9.5-24). At the last follow-up, 76% of aneurysms showed complete or near-complete occlusion (O'Kelly-Marotta scale C or D, Raymond-Roy 1 or 2). Overall, thromboembolic or hemorrhagic complications occurred in 14% of patients, with two cases being symptomatic. The mortality rate was 0%, and the retreatment rate was 1.3%.
CONCLUSION
In this multicenter series, the SVB flow diverter represented a valuable treatment option for distal anterior cerebral artery (DACA) aneurysms.
目的
由于管腔直径狭窄和血管迂曲，使用血流导向装置治疗小口径血管动脉瘤具有挑战性，这使得使用标准微导管的传统装置的导航和部署变得复杂。Silk Vista Baby（SVB，法国巴尔市蒙特莫朗西的 Balt 公司）血流导向装置是为治疗位于较小血管或更远端节段的颅内动脉瘤而开发的，并且与 0.017″微导管兼容。我们展示了迄今为止最大规模的多中心分析，评估了 SVB 用于未破裂的大脑前动脉远端（DACA）动脉瘤的治疗结果。
方法
回顾了 20 个中心的回顾性数据，这些数据来自接受 SVB 治疗的未破裂 DACA 动脉瘤患者。记录人口统计学信息、临床表现、影像学特征、并发症和治疗结果。
结果
2018 年 1 月至 2022 年 12 月期间治疗了 79 例患者（79 个 DACA 动脉瘤）；59 例为女性（74.7%），中位年龄为 61 岁（四分位间距 53 - 67 岁）。大多数动脉瘤为囊状（89.9%），65.8%累及分支。母血管中位直径为 1.9 mm（四分位间距 1.7 - 2.1）。97.5%的病例植入了单个支架；2.5%需要两个支架。影像学中位随访时间为 12 个月（四分位间距 9.5 - 24）。在最后一次随访时，76%的动脉瘤显示完全或接近完全闭塞（奥凯利 - 马罗塔分级 C 或 D，雷蒙德 - 罗伊分级 1 或 2）。总体而言，14%的患者发生了血栓栓塞或出血性并发症，其中两例有症状。死亡率为 0%，再治疗率为 1.3%。
结论
在这个多中心系列研究中，SVB 血流导向装置是大脑前动脉远端（DACA）动脉瘤的一种有价值的治疗选择。
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