| 血流导向装置治疗颅内动脉瘤的疗效分析 |
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| 引用本文： | 毛立武,王天玉,康玉琪,刘俊中,时伟玉,郭广涛,王圣杰.血流导向装置治疗颅内动脉瘤的疗效分析[J].中国临床神经外科杂志,2022,27(6):433-436. |
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| 作者姓名： | 毛立武 王天玉 康玉琪 刘俊中 时伟玉 郭广涛 王圣杰 |
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| 作者单位： | 450000 郑州，郑州大学附属郑州中心医院神经介入科（毛立武、王天玉、康玉琪、刘俊中、时伟玉、郭广涛、王圣杰） |
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| 摘 要： | 目的 探讨血流导向装置治疗颅内动脉瘤的疗效及安全性。方法 回顾性分析2019年5月至2021年4月行Pipeline Flex血流导向装置治疗的53例（68个动脉瘤）的颅内动脉瘤的临床资料。结果 53例68个动脉瘤，共置入60枚PED，技术成功率为100%。40例54个动脉瘤单纯应用PED治疗，术后即刻造影显示动脉瘤内造影剂明显滞留48个，无明显滞留6个；13例（14个动脉瘤）联合应用PED和弹簧圈栓塞，术后即刻造影均致密栓塞。围手术期总并发症发生率为7.5%（4/53）。53例临床随访6~28个月（中位数12个月）；末次随访时，47例未破裂动脉瘤预后良好（mRS评分≤2分）；6例破裂动脉瘤中，预后良好2例，mRS评分3分1例，4分1例，死亡2例。46例DSA随访4~8个月（中位数6个月），动脉瘤完全闭塞率为67.9%。22例（28个动脉瘤）DSA随访9~18个月（中位数12个月），动脉瘤完全闭塞率为85.7%，无动脉瘤复发。结论 血流导向装置治疗颅内动脉瘤总体安全、有效，但对颅内破裂动脉瘤的安全性仍需进一步研究。
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| 关 键 词： | 颅内动脉瘤 血管内治疗 血流导向装置 疗效 |
Efficacy and safety of flow diverter for patients with intracranial aneurysm |
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| MAO Li-wu,WANG Tian-yu,KANG Yu-qi,LIU Jun-zhong,SHI Wei-yu,GUO Guang-tao,WANG Sheng-jie.Efficacy and safety of flow diverter for patients with intracranial aneurysm[J].Chinese Journal of Clinical Neurosurgery,2022,27(6):433-436. |
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| Authors: | MAO Li-wu WANG Tian-yu KANG Yu-qi LIU Jun-zhong SHI Wei-yu GUO Guang-tao WANG Sheng-jie |
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| Affiliation: | Department of Neurointerventional Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China |
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| Abstract: | Objective To investigate the outcomes of flow diverter for the patients with intracranial aneurysm. Methods The clinical data of 53 patients with intracranial aneurysm who were treated with Pipeline Flex flow diverter from May 2019 to April 2021 were retrospectively analyzed. Perioperative complications were recorded. Neurological prognosis was asessed using modified Rankin scale (mRS) score, with a mRS score≤2 as good prgnosis. Aneurysm occlusion after operation was evaluated using O'Kelly-Marotta grade, with grade D as complete embolization. Results A total of 60 PEDs were implanted in 53 patients with 68 aneurysms, and the technical success rate was 100%. Immediate postoperative angiography showed significant retention of the contrast agent in 48 of 54 aneurysms of 40 patients who were treated with simple PED, and no retention in the other 6 aneurysms. Immediate angiography showed complete embolization was achieved in 14 aneurysms of 13 patients who were treated with PED combined with coil embolization. The total perioperative complication rate was 7.5% (4/53). The clinical follow up of 53 patients (range, 6~28 months; median, 12 months) showed that 47 patients with unruptured aneurysm had good prognosis, 2 patients with ruptured aneurysm had good prognosis, 1 patients with ruptured aneurysm had mRS score of 3, 1 patients with ruptured aneurysm had mRS score of 4, and 2 patients with ruptured aneurysm died. The DSA follow up of 46 patients (range, 4~8 months; median, 6 months) showed a complete occlusion rate of 67.9%. The DSA follow up of 22 patients (range, 9~18 months; median, 12 months) showed a complete occlusion rate of 85.7%, and no recurrence of aneurysm. Conclusions The flow diverter is generally safe and effective for the patients with intracranial aneurysm, but the safety of flow diverter for the ruptured intracranial aneurysms needs further study. |
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| Keywords: | Intracranial aneurysm Endovascular treatment Flow diverter Safety Efficacy |
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