Preliminary efficacy analysis of the flow diverter in the treatment of vertebral artery segment dissecting an-eurysm
10.3969/j.issn.1002-0152.2024.06.007
- VernacularTitle:血流导向装置治疗椎动脉夹层动脉瘤疗效分析
- Author:
Shihao JIANG
1
;
Yuan XIA
;
Aizimaitijiang TUERXUN
;
Yiliyaer DILIXIATI
;
Kai WANG
;
Aximujiang AXIER
;
Kaheerman KADEER
;
Riqing SU
;
Zengliang WANG
;
Xiaojiang CHENG
;
Maimaitili AISHA
;
Nizamidingjiang REXIATI
Author Information
1. 新疆医科大学第一附属医院神经外科中心(乌鲁木齐 830054)
- Keywords:
Flow diverter;
Endovascular treatment;
Vertebral artery;
Dissecting aneurysm;
Clinical efficacy
- From:
Chinese Journal of Nervous and Mental Diseases
2024;50(6):355-359
- CountryChina
- Language:Chinese
-
Abstract:
Objective A preliminary study of the safety and efficacy of the Pipeline embolization device(PED)for the treatment of vertebral artery dissecting aneurysm(VADA).Methods Clinical data of 21 patients with VADA treated with PED in the Department of Neurosurgery of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to June 2023 were retrospectively collected,and the surgical approach,perioperative complications,and imaging results were recorded and followed up.Patients'prognosis was assessed by modified Rankin Scale score(mRS),and Kamran grading was used for imaging follow-up.Results Of the 21 patients,17 had unruptured aneurysms and 4 had ruptured aneurysms.A total of 22 PEDs were placed,of which 13 patients underwent PED placement alone and 8 patients underwent PED combined with coil embolization,with a technical success rate of 100% .Three patients with ruptured aneurysms had combined stenosis proximal to the aneurysm,and 1 patient with>50% stenosis received an additional Solitaire stent for in-stent posterior dilatation.Immediate postoperative Kamran grading was grade 1 in 16 patients,grade 2 in 1 patient,and grade 3 in 4 patients.There were 2 perioperative complications,including postoperative aneurysm rupture in 1 patient and severe pulmonary infection in 1 patient who eventually died.At the time of discharge,15 patients had an mRS score of 1,2 patients had a score of 2,1 patient had a score of 3,1 patient had a score of 4,and 2 patient had a score of 6.Eighteen patients were followed up with a median follow-up time of 12.5(6-30)months,of which 13 patients had an mRS score of 0,4 patients had a score of 1,and 1 patient had a score of 2.There were 2 patients with a Kamran grade of 2,4 patients with a grade of 3,and 12 patients with a grade of 4.Conclusion The surgical success rate and safety of VADA treatment with PED is high,but perioperative complications and postoperative care should not be ignored either and a large number of samples are still needed for further study in the future.
