Flow-diverter devices in complex intracranial aneurysm: a complication analysis
10.3760/cma.j.cn115354-20230816-00065
- VernacularTitle:血流导向装置治疗复杂颅内动脉瘤的并发症分析
- Author:
Minghao YANG
1
;
Jianxun TANG
;
Bao CHEN
;
Na LI
;
Zhonghui YANG
;
Ligang HU
;
Jingfeng TANG
Author Information
1. 桂林医学院第二附属医院脑血管病科，桂林 541199
- Keywords:
Flow-diverter device;
Intracranial aneurysm;
Complication
- From:
Chinese Journal of Neuromedicine
2023;22(11):1129-1135
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the complications of complex intracranial aneurysms after intervention with flow-diverter (FD) devices.Methods:Sixty patients with complex intracranial aneurysms accepted FD devices in Department of Cerebrovascular Diseases, Second Affiliated Hospital of Guilin Medical University from July 2018 to June 2021 were chosen. Clinical and imaging data of these patients were retrospectively analyzed, and complications were recorded: procedure-related adverse events, early postprocedural complications, complications during follow-up, and covered branch occlusion.Results:A total of 61 FD devices (47 Pipeline Flex, 10 Tubridge, 4 Surpass Streamline) were implanted in 60 patients. Incidence of procedure-related adverse events was 8.3% (5/60), including 3 with incomplete stent apposition, 1 with intraoperative bleeding, 1 with aneurysm neck not covered by stent; incidence of early postprocedural complications was 6.7% (4/60), including 3 with hemorrhagic complication and 1 with ischemic complication. DSA follow-up ([22.7±16.8] months) was completed in 54 patients; aneurysm healed rate was 83.3% (45/54). First DSA follow-up 6 months after surgery showed that in-stent restenosis was 7.4% (4/54), of which 2 deteriorated to parent vessel occlusion at 2- and 3-year after procedure, respectively. A total of 78 branch arteries were covered by FD devices, and only 1 (1.3%, 1/78) demonstrated branch artery occlusion at last follow-up, without clinical symptoms.Conclusion:The complications of complex intracranial aneurysms after intervention with FD devices should be recognized; incomplete stent apposition is the main procedure-related adverse event, and hemorrhagic complication mainly appear in the early postprocedural period; in-stent restenosis should be vigilant during follow-up.
