血流导向装置与传统血管内重建治疗椎动脉夹层动脉瘤对比研究  

Flow diverter device versus traditional endovascular reconstruction for vertebral dissecting aneurysms:a comparative study

作　　者：宋稳鹏 白京岳 孟庆斌 范锋[1] 管生[1] SONG Wenpeng;BAI Jingyue;MENG Qingbin;FAN Feng;GUAN Sheng(Department of Neurointervention,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China)

机构地区：[1]郑州大学第一附属医院神经介入科,450052

出　　处：《介入放射学杂志》2022年第6期545-549,共5页Journal of Interventional Radiology

摘　　要：目的 探讨血流导向装置(FD)与传统血管内重建治疗椎动脉夹层动脉瘤(VADA)的安全性和有效性.方法 回顾性分析2018年1月至2021年1月郑州大学第一附属医院采用介入手术治疗的72例VADA患者临床资料.其中男41例,女31例.根据治疗方式不同分为FD治疗组(n=25)和传统血管内治疗组(n=47).对比分析两种术式治疗效果.结果 传统血管内治疗组瘤体破裂患者占比较多(P=0.043),FD治疗组患者年龄较小(P=0.041),动脉瘤长径较大(P=0.018).两组患者随访(12.1±5.8)个月,范围为3~30个月.围手术期及随访结果显示,FD治疗、传统血管内治疗均能达到较高的动脉瘤闭塞率(83.3%比85.7%),疗效间差异无统计学意义(P=0.749).FD治疗组围手术期及远期并发症发生率更低(0比10.6%).结论 FD与传统血管内重建治疗VADA均安全有效,初步结果表明FD治疗后并发症及再治疗发生率较低、更安全.远期疗效有待多中心大规模研究进一步验证.Objective To compare the clinical safety and efficacy of flow diverter(FD)device with traditional intravascular reconstruction therapy in the treatment of vertebral artery dissecting aneurysm(VADA).Methods The clinical data of a total of 72 patients with VADA,who received interventional therapy at the First Affiliated Hospital of Zhengzhou University of China between January 2018 and January 2021,were retrospectively analyzed.Of the 72 patients,41 were males and 31were females.Based on the therapeutic methods,the patients were divided into FD group(receiving FD device therapy,n=25)and traditional group(receiving traditional intravascular reconstruction therapy,n=47).The curative effect was compared between the two groups.Results The proportion of patients who had ruptured aneurysm in the traditional group was obviously higher than that in the FD group(P=0.043),while the patients of FD group were younger than the patients of the traditional group(P=0.041),and the long diameter of the aneurysm in FD group was longer than that in the traditional group(P=0.018).All patients of both groups were followed up for a mean period of(12.1±5.8)months(range of 3-30 months).The perioperative and follow-up check-ups indicated that the aneurysm occlusion rates in FD group and traditional group were up to 83.3%and 85.7%respectively,and no statistically significant difference in the curative effect existed between the two groups(P=0.749).The incidence of perioperative complications and long-term complications in FD group was 0%,which in the traditional group was 10.6%.Conclusion For the treatment of VADA,both FD device and the traditional endovascular reconstruction are safe and effective.The preliminary results of this study indicate that FD device therapy carries lower incidence of complications with less need of re-treatment,and its therapeutic procedure is safer.However,multi-center large-scale studies need to be conducted before its long-term efficacy can be validated.

关 键 词：颅内动脉瘤 椎动脉夹层 血流导向装置 血管内重建 疗效对比 

分 类 号：R743.3[医药卫生—神经病学与精神病学]