Curative effect of different types of stents treating vertebrobasilar dissection aneurysms
10.19405/j.cnki.issn1000-1492.2024.12.018
- Author:
Yang Wang
1
;
Xiaoyu Sun
1
;
Jiajia Xu
1
;
Yu Jian
1
;
Yingjiu Chao
1
;
Ge Gao
1
Author Information
1. Dept of Neurosurgery , The First Afiliated Hospital ofUniversity of Science and Technology of China (Anhui Provincial Hospital) , Hefei 230001
- Publication Type:Journal Article
- Keywords:
vertebrobasilar artery dissecting aneurysm;
laser engraved stent;
braided stent;
endovascular therapy;
ischemia complication;
hemorrhage complication
- From:
Acta Universitatis Medicinalis Anhui
2024;59(12):2190-2197
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the safety and effectiveness of different types of stents with the treatment of vertebraebasilar artery dissection aneurysms(VBADA).
Methods :The clinical data of 80 patients with VBADA treated by intravascular intervention in the First Hospital of University of Science and Technology of China(Anhui Provincial Hospital) from February 2018 to November 2023 were retrospectively analyzed. Patients were divided into laser engraved stent group(n=34) and braided stent group(n=46) based on the type of stent used. O′Kelly-Marotta(OKM) grade was used to evaluate the embolization effect of aneurysms in DSA images, and a modified Rankin Scale(mRS) score was used to evaluate the clinical prognosis of patients. The baseline data, aneurysm characteristics, intraoperative and perioperative treatment details and postoperative follow-up details between the two groups were compared.
Results :There was no significant difference in baseline data, mRS score, ischemic and hemorrhage complications and mortality between the two groups(allP>0.05). Compared with the laser engraved stent group, the mean diameter of aneurysms was larger(P<0.000 1) and the proportion of ruptured aneurysm(P<0.01), parent artery stenosis and beaded vascular lesions(P<0.05) and branch artery dissecting aneurysm were higher(P<0.01) in the braided stent group. Conversely, the proportion of coil-assisted embolization(P<0.000 1) and the immediate aneurysm occlusion rate(OKM C and D)(P<0.000 1) were lower. Finally, 21 patients were obtained by controlling for maximum diameter of aneurysms and whether coil-assisted embolization, the aneurysm occlusion rate half a year later in the braided stent group was higher than that in the laser engraved stent group(P<0.05), but the recurrence rate of postoperative aneurysm was lower than that of laser engraved stent group(P<0.05). It was worth noting that the cure rate and vascular remodeling rate of middle-large size VBADA which the maximum diameter being over 15 mm in the braided stent group reached 72.2%, and the whole effect was ideal.
Conclusion :Braided stents are relatively safe and effective in the treatment of VBADA and are significantly better than laser engraved stents in reducing VBADA recurrence and remodeling lesion vessels without increasing postoperative complication.
- Full text:2025022716461974228不同类型支架治疗椎-基底动脉夹层动脉瘤的疗效_汪洋.pdf
