Analysis of perioperative complications of flow-diverter devices in the treatment of unruptured intracranial aneurysms
10.3760/cma.j.cn112139-20240522-00253
- VernacularTitle:血流导向装置治疗颅内未破裂动脉瘤的围手术期并发症分析
- Author:
Xiaohui WANG
1
;
Rongju ZHANG
;
Nan TIAN
;
Zhihua DU
;
Xinfeng LIU
;
Bin LYU
;
Yang BIAN
;
Xiangyu CAO
;
Jun WANG
Author Information
1. 解放军总医院第一医学中心神经内科医学部神经介入科，北京 100853
- Keywords:
Aneurysm;
Carotid artery diseases;
Unruptured internal carotid artery aneurysms;
Flow-diverter devices;
Intracranial aneurysm;
Complications;
Adverse events
- From:
Chinese Journal of Surgery
2024;62(12):1094-1103
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the perioperative adverse events and complications of flow-diverter devices in the treatment of unruptured intracranial aneurysms.Methods:This is a retrospective case series study. The clinical and imaging data of 174 patients with unruptured intracranial aneurysms treated with flow-diverter devices in the Department of Neurointervention, Department of Neurology, the First Medical Center of Chinese People′s Liberation Army General Hospital from January 2020 to January 2024 were retrospectively analyzed. There were 63 males and 111 females, with an age of (53.9±11.4) years (range:23 to 76 years).The occurrence, development and outcome of perioperative complications and related adverse events during treatment were collected and analyzed. The degree of aneurysm embolization was evaluated using the O′Kelly-Marotta (OKM) grading system,with OKM grade C and D as successful occlusion.Results:A total of 187 flow-diverter devices (from 7 different brands) were implanted in 174 patients (with 294 aneurysms). Of these, 151 cases involved standalone stent embolization, 26 cases involved stent embolization combined with coil assistance, and 5 cases involved the use of two flow-diverter devices simultaneously. Twenty-nine cases (16.7%,29/174) suffered intraoperative adverse events, including 10 cases of poor stents deployment, 3 cases of stents migration into the aneurysm sac, 1 cases of abnormal guidewire movement, 4 cases of ischemic events. Complications occurred in 10 patients (5.7%, 10/174), and neurological deficits occurred in 5 patients (2.9%, 5/174). A total of 129 patients completed follow-up for more than 12 months after surgery. There were 117 aneurysms with OKM grade D and 22 with OKM grade C, showing a satisfactory healing rate of 77.7% (139/179).Conclusion:The effect of flow-diverter devices in the treatment of intracranial aneurysms is satisfactory, but complications and adverse events cannot be ignored, especially the relatively high incidence of perioperative adverse events, which requires neurointerventional physicians to be vigilant.
