中短期随访时未发生支架内狭窄的Pipeline血流导向装置的长期随访结果  

Long term follow-up results of pipeline embolization devices showing no in-stent stenosis at short-to-medium term follow-up examination

作　　者：李元智 张航[1] 马亚静 司明磊 付宇 郭新宾[1] 王林玉[1] 管生[1] LI Yuanzhi;ZHANG Hang;MA Yajing;SI Minglei;FU Yu;GUO Xinbin;WANG Linyu;GUAN Sheng(Department of Neurointervention,First Affiliated Hospital,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,河南郑州450052

出　　处：《介入放射学杂志》2024年第10期1057-1063,共7页Journal of Interventional Radiology

摘　　要：目的探究Pipeline血流导向装置(pipeline embolization device,PED)治疗颅内动脉瘤术后中短期随访时无支架内狭窄(in-stent stenosis,ISS)的患者在长期随访时ISS的发生率。方法回顾性收集2015年4月至2022年6月在郑州大学第一附属医院神经介入科接受PED治疗的患者资料,筛选出首次DSA随访时未发生ISS并完成术后12个月以上长期随访的颅内动脉瘤患者。收集其相关的临床及影像资料,统计在术后12个月以上的长期随访时ISS的发生率。ISS定义为随访时支架所在范围载瘤动脉较术后即刻管腔丢失>25%。结果本研究57例患者共61枚动脉瘤,置入68枚PED,41枚(67.21%)动脉瘤采用单独PED植入,20枚(32.79%)动脉瘤采用PED联合弹簧圈栓塞。中位初次随访时间184.0(119.0,212.5)d,术后12个月以上的长期随访时,35枚(57.38%)动脉瘤采用DSA随访,22枚(36.07%)动脉瘤采用CTA随访,4枚(6.56%)动脉瘤采用磁共振3D-SPACE序列随访。中位术后长期随访时间538.0(407.5,678.0)d,ISS发生率为0。所有患者均未出现ISS相关神经系统症状。结论PED治疗颅内动脉瘤术后ISS发生率低,短期随访时未发现ISS者,长期随访倾向于无ISS事件发生。Objective To investigate the long-term incidence of in-stent stenosis(ISS)in patients with intracranial aneurysms receiving pipeline embolization device(PED)who showed no ISS at short-to-medium term follow-up examination.Methods The clinical data of patients,who received PED treatment at the Department of Neurointervention,First Affiliated Hospital of Zhengzhou University of China between April 2015 and June 2022,were retrospectively collected.The patients with intracranial aneurysms,who showed no ISS at the initial follow-up with DSA and completed>12 months long-term follow-up check after treatment at the same hospital,were screened out,and their relevant clinical data and imaging materials were collected.The incidence of ISS occurring in postoperative>12 months long-term follow-up was calculated.The ISS was defined as a>25%lumen loss of the parent artery when compared with its lumen size measured immediately after PED implantation.Results A total of 57 patients with 61 aneurysms were enrolled in this study,and a total of 68 PEDs were implanted.Forty-one(67.21%)aneurysms were treated by PED implantation only,and 20(32.79%)aneurysms by PED plus spring coils.The median initial follow-up time was 184.0 days(119.0,212.5).At postoperative>12 months long-term follow-up visit,DSA was employed for 35(57.38%)aneurysms,CTA was adopted for 22(36.07%)aneurysms,and 3D-SPACE sequence MR scan was performed in 4(6.56%)aneurysms.The median follow-up time was 538.0 days(407.5,678.0),and the incidence of ISS was 0%.No ISS-related neurological symptoms occurred in all patients.Conclusion In treating intracranial aneurysms with PED,the postoperative incidence of ISS is low.No ISS is found during the short-term follow-up period,and long-term follow-up results tend to indicate that no ISS events have occurred.

关 键 词：颅内动脉瘤 Pipeline血流导向装置 支架内狭窄 长期随访 

分 类 号：R651[医药卫生—外科学]