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Abstract：
BACKGROUND: More data is needed on the short- and medium-term efficacy and safety of the Willis covered stent in treating distal internal carotid artery (DICA) aneurysms and vertebral artery dissecting aneurysms (VADAs).
METHODS: Records of all 42 patients with DICA aneurysms or VADAs treated with the Willis covered stents at our institute between July 2014 and January 2019 were retrospectively examined. The patients\' demographic information, symptoms, diagnosis, treatment procedure, immediate and follow-up clinical and angiographic outcomes were extracted.
RESULTS: 46 Willis covered stents were successfully implanted in all of the 42 patients (total 43 aneurysms). Immediate complete aneurysm occlusion was achieved in 37 patients (38 aneurysms) (88.4%), and endoleak occurred to 5 patients (5 aneurysms) (11.6%). 2 patients died post-operatively from procedure-related complications, another one died from reasons unrelated to the procedure. Among the remaining 39 patients, non-lethal complications occurred in 4 patients including ptosis and diplopia of the right eye, intra-operative hemorrhage and carotid cavernous fistulas (CCF). Angiographic and clinical follow-ups (means ± standard deviation: 8.8 ± 5.3 months) were done for 32 patients (33 aneurysms). Complete occlusion was maintained in all of the 33 aneurysms. 2 of the 32 patients had significant though asymptomatic parent artery (PA) occlusion. No ischemic or hemorrhagic event occurred during the follow-up period. The modified Rankin Scale (mRS) score was 0 in 31 patients and 1 in the remaining 1 patient.
CONCLUSIONS: The Willis covered stent could be a safe and effective treatment for complex DICA aneurysms with excellent durability. In addition, the Willis covered stent treated all of the 3 cases of VADAs in the study with complete success without any complications, however, as the number of the VADA cases was small, more cases are needed to further confirm the efficacy and safety of the Willis covered stent in treating VADAs.
METHODS: Records of all 42 patients with DICA aneurysms or VADAs treated with the Willis covered stents at our institute between July 2014 and January 2019 were retrospectively examined. The patients\' demographic information, symptoms, diagnosis, treatment procedure, immediate and follow-up clinical and angiographic outcomes were extracted.
RESULTS: 46 Willis covered stents were successfully implanted in all of the 42 patients (total 43 aneurysms). Immediate complete aneurysm occlusion was achieved in 37 patients (38 aneurysms) (88.4%), and endoleak occurred to 5 patients (5 aneurysms) (11.6%). 2 patients died post-operatively from procedure-related complications, another one died from reasons unrelated to the procedure. Among the remaining 39 patients, non-lethal complications occurred in 4 patients including ptosis and diplopia of the right eye, intra-operative hemorrhage and carotid cavernous fistulas (CCF). Angiographic and clinical follow-ups (means ± standard deviation: 8.8 ± 5.3 months) were done for 32 patients (33 aneurysms). Complete occlusion was maintained in all of the 33 aneurysms. 2 of the 32 patients had significant though asymptomatic parent artery (PA) occlusion. No ischemic or hemorrhagic event occurred during the follow-up period. The modified Rankin Scale (mRS) score was 0 in 31 patients and 1 in the remaining 1 patient.
CONCLUSIONS: The Willis covered stent could be a safe and effective treatment for complex DICA aneurysms with excellent durability. In addition, the Willis covered stent treated all of the 3 cases of VADAs in the study with complete success without any complications, however, as the number of the VADA cases was small, more cases are needed to further confirm the efficacy and safety of the Willis covered stent in treating VADAs.
摘要：
背景：需要更多关于Willis覆膜支架治疗颈内动脉远端（DICA）动脉瘤和椎动脉夹层动脉瘤（VADAs）的短期和中期疗效和安全性的数据。
方法：回顾性检查了2014年7月至2019年1月在我们研究所接受Willis覆盖支架治疗的所有42例DICA动脉瘤或VADAs患者的记录。患者的人口统计信息，症状,诊断,治疗程序,提取即时和随访的临床和血管造影结果.
结果：46例Willis覆膜支架成功植入42例患者（共43个动脉瘤）。37例患者（38例）（88.4%）实现了动脉瘤立即完全闭塞，5例患者(5个动脉瘤)发生内漏(11.6%)。2例死于手术相关并发症,另一人死于与手术无关的原因。在剩下的39名患者中，4例患者发生非致死性并发症，包括右眼上睑下垂和复视，术中出血和颈动脉海绵窦瘘（CCF）。对32例患者（33个动脉瘤）进行了血管造影和临床随访（平均值±标准偏差：8.8±5.3个月）。在所有33个动脉瘤中均保持完全闭塞。32例患者中有2例尽管无症状但仍存在明显的父动脉（PA）闭塞。随访期间无缺血或出血性事件发生。31例患者的改良Rankin量表（mRS）评分为0，其余1例患者为1。
结论：Willis覆膜支架是治疗复杂DICA动脉瘤的一种安全有效的方法，具有良好的耐久性。此外,Willis覆膜支架治疗研究中所有3例VADAs均取得圆满成功，无任何并发症，然而,由于VADA病例数量很少，需要更多病例进一步确认Willis覆膜支架治疗VADAs的有效性和安全性.
方法：回顾性检查了2014年7月至2019年1月在我们研究所接受Willis覆盖支架治疗的所有42例DICA动脉瘤或VADAs患者的记录。患者的人口统计信息，症状,诊断,治疗程序,提取即时和随访的临床和血管造影结果.
结果：46例Willis覆膜支架成功植入42例患者（共43个动脉瘤）。37例患者（38例）（88.4%）实现了动脉瘤立即完全闭塞，5例患者(5个动脉瘤)发生内漏(11.6%)。2例死于手术相关并发症,另一人死于与手术无关的原因。在剩下的39名患者中，4例患者发生非致死性并发症，包括右眼上睑下垂和复视，术中出血和颈动脉海绵窦瘘（CCF）。对32例患者（33个动脉瘤）进行了血管造影和临床随访（平均值±标准偏差：8.8±5.3个月）。在所有33个动脉瘤中均保持完全闭塞。32例患者中有2例尽管无症状但仍存在明显的父动脉（PA）闭塞。随访期间无缺血或出血性事件发生。31例患者的改良Rankin量表（mRS）评分为0，其余1例患者为1。
结论：Willis覆膜支架是治疗复杂DICA动脉瘤的一种安全有效的方法，具有良好的耐久性。此外,Willis覆膜支架治疗研究中所有3例VADAs均取得圆满成功，无任何并发症，然而,由于VADA病例数量很少，需要更多病例进一步确认Willis覆膜支架治疗VADAs的有效性和安全性.
