Pipeline Flex血流导向装置治疗后循环大型动脉瘤单中心临床经验  

Pipeline Flex embolization device for the treatment of posterior circulation large aneurysms: singlecenter clinical experience

作　　者：吴桥伟 李立 邵秋季 贺迎坤 李天晓 李航 白卫星 WU Qiaowei;LI Li;SHAO Qiuji;HE Yingkun;LI Tianxiao;LI Hang;BAI Weixin(Department of Cerebrovascular Disease,People’s Hospital of Zhengzhou University,Henan Provincial People’s Hospital,Zhengzhou,Henan Province 450003,China)

机构地区：[1]郑州大学人民医院(河南省人民医院)脑血管病科,450003

出　　处：《介入放射学杂志》2021年第1期1-4,共4页Journal of Interventional Radiology

基　　金：“十三五”国家重点研发计划项目(2016YFC1300702);国家自然科学基金(81601583);河南省医学科技攻关计划项目(201702167)。

摘　　要：目的探讨Pipeline Flex血流导向装置(PED)治疗后循环大型动脉瘤(PCLA)的安全性和有效性。方法回顾性纳入2018年6月至2019年9月在郑州大学人民医院接受PED治疗的14例PCLA患者(14枚动脉瘤,最大径≥10 mm)。均为单发未破裂动脉瘤,位于基底动脉主干3例,椎动脉V4段11例。采用改良Rankin量表(mRS)评分评估患者临床预后,O’Kelly-Marotta(OKM)分级评估动脉瘤闭塞情况。结果 14例患者植入14枚PED,其中4例结合弹簧圈填塞,手术均获成功,支架均成功释放且贴壁良好。未发现神经系统并发症,出院时mRS评分2分1例,1分2例,0分11例。14例患者均获临床中位随访8(2~18)个月,疗效良好(mRS评分均为0分);11例获DSA中位随访6(3~7)个月,OKM分级D级7例,C级1例,B级3例,均未见支架内狭窄。结论 PED治疗PCLA成功率高,安全性好,6个月影像学随访有较高的完全闭塞率。Objective To evaluate the safety and effectiveness of Pipeline Flex embolization device(PED),i.e. a flow diverter device,in treating posterior circulation large aneurysm(PCLA). Methods A total of 14 patients with PCLA(14 aneurysms in total,maximum diameter ≥10 mm),who were admitted to the People’s Hospital of Zhengzhou University of China between June 2018 to September 2019 to receive PED treatment,were enrolled in this retrospective study. All 14 patients suffered from single unruptured aneurysm.The aneurysms were located at basilar artery trunk(n=3) and vertebral artery V4 segment(n=11). Modified Rankin Scale(mRS) score was used to evaluate clinical prognosis of patients,and O’Kelly-Marotta(OKM)grading scale was used to evaluate the occlusion degree of aneurysms. Results A total of 14 PEDs were implanted in the 14 patients,and in 4 of them additional occlusion with spring coil was carried out. Successful operation was accomplished in all patients. All stents were successfully released and well adhered to the vascular wall. No neurological complications were observed. At the time of discharge,mRS score of 2 points was seen in one patient,one point in 2 patients,and 0 point in 11 patients. The 14 patients were followed up for a mean of 8 months(2-18 months) and all patients achieved good curative effect(mRS score of 0 point).Eleven patients were followed up for a median of 6.0 months(3-7 months) with DSA,which showed that OKM grade D was obtained in 7 patients,grade C in one patient,and grade B in 3 patients,and no in-stent stenosis was found. Conclusion In treating PCLA,PED carries higher technical success rate and satisfactory safety,and the postoperative 6-month complete occlusion rate is higher.(J Intervent Radiol,2021,30:1-4)

关 键 词：血流导向装置 后循环动脉瘤 颅内动脉瘤 大型 随访研究 

分 类 号：R743.34[医药卫生—神经病学与精神病学]