| pipeline栓塞装置治疗大脑中动脉动脉瘤的疗效：一项回顾性多中心研究 |
| |
| 引用本文： | 张莹,罗斌,康慧斌,刘健,张义森,杨新健,张鸿祺,李天晓,买买提力·艾沙,毛国华,宋冬雷,王云彦,冯文峰,汪阳,史怀璋,万杰清,刘建民,管生,赵元立,王超.pipeline栓塞装置治疗大脑中动脉动脉瘤的疗效：一项回顾性多中心研究[J].中国临床神经外科杂志,2023,28(4):225-229. |
| |
| 作者姓名： | 张莹 罗斌 康慧斌 刘健 张义森 杨新健 张鸿祺 李天晓 买买提力·艾沙 毛国华 宋冬雷 王云彦 冯文峰 汪阳 史怀璋 万杰清 刘建民 管生 赵元立 王超 |
| |
| 作者单位： | 1. 北京市神经外科研究所神经介入室/首都医科大学附属北京天坛医院神经外科;2. 北京大学国际医院神经外科;3. 南方医科大学南方医院神经外科;4. 首都医科大学宣武医院神经外科;5. 河南省人民医院介入科;6. 新疆医科大学第一附属医院神经外科;7. 南昌大学第二附属医院神经外科;8. 上海冬雷脑科医院神经外科;9. 山东大学齐鲁医院神经外科;10. 南昌大学第一附属医院神经外科;11. 哈尔滨医科大学附属第一医院神经外科;12. 上海交通大学医学院附属仁济医院神经外科;13. 海军军医大学第一附属医院神经外科;14. 郑州大学第一附属医院神经介入科 |
| |
| 摘 要： | 目的 探讨pipeline栓塞装置（PED）治疗大脑中动脉（MCA）动脉瘤的临床效果。方法 回顾性分析2014年11月至2019年10月我国14个临床中心采用PED治疗的33例MCA动脉瘤的临床资料、影像学资料和随访资料。结果 33例共39个动脉瘤，使用37个PED。33例完成临床随访，30例（36个动脉瘤）完成影像随访；随访时间4～22个月，平均（10.6±6.3）个月；动脉瘤完全或近全闭塞30个（83.3%,30/36）；相对于单纯PED治疗组（71.4%）,PED辅助弹簧圈栓塞组动脉瘤闭塞率更高（100%;P=0.031）；预后不良（m RS评分>2分）3例（9.1%），预后良好（mRS评分≤2分）30例（90.9%）；术后并发症发生率为24.2%(8/33)，术前规律服用双抗药物3 d以上病人术后并发症发生率明显低于未规律服用双抗药物的病人（P=0.033）。结论 MCA动脉瘤可以采用PED治疗，疗效较满意。对于直径大、形态不规则的MCA动脉瘤，可使用PED结合弹簧圈栓塞治疗以获得更高的闭塞率。术前、术后应规范应用双抗药物以减少缺血、出血并发症。
|
| 关 键 词： | 颅内动脉瘤 大脑中动脉 血流导向装置 pipeline栓塞装置(PED) 疗效 |
Clinical efficacy of pipeline embolization devices for patients with middle cerebral artery aneurysms: a retrospective multicenter study |
| |
| ZHANG Ying,LUO Bin,KANG Hui-bin,LIU Jian,ZHANG Yi-sen,YANG Xin-jian,ZHANG Hong-qi,LI Tian-xiao,MAIMAITILI Aisha,MAO Guo-hua,SONG Dong-lei,WANG Yun-yan,FENG Wen-feng,WANG Yang,SHI Huai-zhang,WAN Jie-qing,LIU Jian-min,GUAN Sheng,ZHAO Yuan-li,WANG Chao.Clinical efficacy of pipeline embolization devices for patients with middle cerebral artery aneurysms: a retrospective multicenter study[J].Chinese Journal of Clinical Neurosurgery,2023,28(4):225-229. |
| |
| Authors: | ZHANG Ying LUO Bin KANG Hui-bin LIU Jian ZHANG Yi-sen YANG Xin-jian ZHANG Hong-qi LI Tian-xiao MAIMAITILI Aisha MAO Guo-hua SONG Dong-lei WANG Yun-yan FENG Wen-feng WANG Yang SHI Huai-zhang WAN Jie-qing LIU Jian-min GUAN Sheng ZHAO Yuan-li WANG Chao |
| |
| Affiliation: | 1.Department of Interventional Neuroradiology, Beijing Neurosurgical Institute & Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; 2.Department of Neurosurgery, Peking University International Hospital, Beijing 102200, China; 3.Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; 4.Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;...... |
| |
| Abstract: | Objective To investigate the clinical efficacy of pipeline embolization devices (PED) for patients with middle cerebral artery (MCA) aneurysms. Methods The clinical data, imaging data and follow-up data of 33 patients with MCA aneurysms treated with PED in 14 clinical centers from November 2014 to October 2019 were retrospectively analyzed. Results Thirty-seven PEDs were used in 33 patients with 39 MCA aneurysms. Clinical follow-up was completed in 33 patients and imaging follow-up was completed in 30 patients (36 aneurysms). The follow-up time ranged from 4 to 22 months, with an average of (10.6±6.3) months. Complete or near complete occlusion of aneurysms were achieved in 30 aneurysms (83.3%, 30/36). Compared with the patients treated with PED alone 71.4%(15/21)], the occlusion rate of aneurysms was significantly higher in the patients treated with PED-assisted coil embolization 100%(15/15); P=0.031]. Thirty patients (90.9%) had good prognoses (mRS score ≤2), and 3 (9.1%) had poor prognoses (mRS score >2). The incidence of postoperative complications was 24.2% (8/33), and patients who received dual antiplatelet therapy for more than 3 days before surgery had a significantly lower incidence of postoperative complications (3.4%) compared to those who did not (50%; P=0.033). Conclusions MCA aneurysms can be treated with PED and the effectiveness is good. For MCA aneurysms with large diameter and irregular morphology, PED combined with coil embolization can obtain a higher occlusion rate. Preoperative and postoperative dual antiplatelet therapies are recommended to decrease ischemia and bleeding complications. |
| |
| Keywords: | Intracranial aneurysm Middle cerebral artery Pipeline embolization device (PED) Clinical efficacy |
|
| 点击此处可从《中国临床神经外科杂志》浏览原始摘要信息 |
|
点击此处可从《中国临床神经外科杂志》下载全文 |
|
