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脉冲骑手动脉瘤颈重建装置与其他治疗方法治疗宽颈分叉动脉瘤患者的系统评价

PulseRider Aneurysm Neck Reconstructive Device Versus Other Treatments in Patients With Wide-Neck Bifurcation Aneurysms: A Systematic Review.

作者信息

Olvera Morales Mariana, Santillán Alcántar Diego, Flores Valdés Jose R, Del Rio Rocha Mariana, Reyes Anaya Mark, Montelongo Quevedo Mauricio, Bujdud Rodríguez Karla Y, Granados García Gilberto, Lora Ponce Luis C, Villar López Sergio A, Navarro Garcia de Llano Juan P

机构信息

General Medicine, Universidad Autónoma de Guadalajara, Guadalajara, MEX.

General Surgery, Instituto Mexicano del Seguro Social Regional General Hospital No. 46, Guadalajara, MEX.

出版信息

Cureus. 2025 Jul 7;17(7):e87479. doi: 10.7759/cureus.87479. eCollection 2025 Jul.

Abstract

Wide-neck bifurcation aneurysms (WNBA) are challenging to treat both surgically and endovascularly due to their complex anatomy. The FDA-approved PulseRider Aneurysm Neck Reconstructive Device (PRANRD; Cerenovus, Johnson & Johnson, Irvine, CA, USA) offers a novel endovascular treatment option; however, comparative data on its safety and efficacy remain limited. This review compares PRANRD with other treatment modalities for unruptured WNBA. A search of multiple databases identified 51 articles, of which three met the inclusion criteria, comprising two cohort studies and one case series, for a total of 134 patients treated with PRANRD. The device achieved complete angiographic occlusion in most cases with low complication rates. Compared to Y-stenting, PRANRD-assisted coiling demonstrated similar immediate occlusion rates but lower complete occlusion rates at six months. No procedure-related mortality was reported. However, long-term follow-up and randomized controlled trials are still required. PRANRD appears to be a promising alternative for treating WNBA, offering high occlusion rates and a favorable safety profile. Further research is necessary to confirm its long-term efficacy and safety.

摘要

宽颈分叉动脉瘤(WNBA)因其复杂的解剖结构,在手术和血管内治疗方面都具有挑战性。美国食品药品监督管理局(FDA)批准的PulseRider动脉瘤颈重建装置(PRANRD;美国加利福尼亚州欧文市的Cerenovus公司,强生公司)提供了一种新型的血管内治疗选择;然而,关于其安全性和有效性的比较数据仍然有限。本综述将PRANRD与未破裂WNBA的其他治疗方式进行了比较。对多个数据库的检索共识别出51篇文章,其中3篇符合纳入标准,包括两项队列研究和一项病例系列,共有134例患者接受了PRANRD治疗。该装置在大多数情况下实现了血管造影完全闭塞,并发症发生率较低。与Y形支架置入术相比,PRANRD辅助弹簧圈栓塞术显示出相似的即刻闭塞率,但在6个月时的完全闭塞率较低。未报告与手术相关的死亡病例。然而,仍需要长期随访和随机对照试验。PRANRD似乎是治疗WNBA的一种有前景的替代方法,具有高闭塞率和良好的安全性。需要进一步研究以证实其长期疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0dc/12329479/5b97efb734a5/cureus-0017-00000087479-i01.jpg

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