PDF(Pubmed)
Abstract：
UNASSIGNED: Favorable wall apposition of a flow diverter (FD) is essential for the treatment of intracranial aneurysms. The irretrievability and final drop point uncertainty of the proximal tail of the FD increase the difficulty of achieving good tail apposition. Therefore, understanding the factors associated with FD tail malapposition would be helpful for clinical practice.
UNASSIGNED: A total of 153 patients with 161 FD deployments in the carotid artery between 2020 and 2023 were retrospectively collected from our center\'s database for this study. Patient demographics, aneurysm characteristics, FDs, carotid artery anatomy, periprocedural complications, discharge modified Rankin scale (MRS) scores, and follow-up outcomes were investigated by comparing patients with and without FD tail malapposition. Comparisons were made with t tests or Kruskal-Wallis tests for continuous variables and the Pearson χ2 or Fisher exact test for categorical variables. Logistic regression was conducted to determine the predictors of malapposition.
UNASSIGNED: Tail malapposition occurred for 41 out of the 161 FDs (25.5%). Univariate analysis revealed that the FD brand, FD length, FD distal to proximal vessel diameter ratio, FD tail position (straight or curved), and curvature of the vessel curve were significantly associated with FD tail malapposition (p < 0.05). Further multivariate analysis demonstrated that the application of a surpass FD (p = 0.04), the FD distal to proximal vessel diameter ratio (p = 0.022), the FD tail position (straight or curved) (p < 0.001) and the curvature of the vessel curve (p < 0.001) were factors significantly associated with FD tail malapposition. No significant difference was found in periprocedural or follow-up outcomes. The classification of FD tail malapposition was determined from imaging. The two major patterns of FD tail malapposition are unattached tails and protrusive tails.
UNASSIGNED: FD tail malapposition might be associated with a larger FD distal to the proximal vessel diameter difference, a curved vessel where the FD tail is located, and a larger curvature of the vessel curve. FD tail malapposition can be classified into unattached tails and protrusive tails, which have their own characteristics and should be noted in clinical practice.
UNASSIGNED: A total of 153 patients with 161 FD deployments in the carotid artery between 2020 and 2023 were retrospectively collected from our center\'s database for this study. Patient demographics, aneurysm characteristics, FDs, carotid artery anatomy, periprocedural complications, discharge modified Rankin scale (MRS) scores, and follow-up outcomes were investigated by comparing patients with and without FD tail malapposition. Comparisons were made with t tests or Kruskal-Wallis tests for continuous variables and the Pearson χ2 or Fisher exact test for categorical variables. Logistic regression was conducted to determine the predictors of malapposition.
UNASSIGNED: Tail malapposition occurred for 41 out of the 161 FDs (25.5%). Univariate analysis revealed that the FD brand, FD length, FD distal to proximal vessel diameter ratio, FD tail position (straight or curved), and curvature of the vessel curve were significantly associated with FD tail malapposition (p < 0.05). Further multivariate analysis demonstrated that the application of a surpass FD (p = 0.04), the FD distal to proximal vessel diameter ratio (p = 0.022), the FD tail position (straight or curved) (p < 0.001) and the curvature of the vessel curve (p < 0.001) were factors significantly associated with FD tail malapposition. No significant difference was found in periprocedural or follow-up outcomes. The classification of FD tail malapposition was determined from imaging. The two major patterns of FD tail malapposition are unattached tails and protrusive tails.
UNASSIGNED: FD tail malapposition might be associated with a larger FD distal to the proximal vessel diameter difference, a curved vessel where the FD tail is located, and a larger curvature of the vessel curve. FD tail malapposition can be classified into unattached tails and protrusive tails, which have their own characteristics and should be noted in clinical practice.
摘要：
■导流器（FD）的有利壁并置对于颅内动脉瘤的治疗至关重要。FD近端尾部的不可恢复性和最终下降点不确定性增加了实现良好尾部并置的难度。因此,了解FD尾部贴壁不良的相关因素将有助于临床实践。
■从我们中心的数据库中回顾性收集了在2020年至2023年之间在颈动脉中有161个FD部署的153例患者，用于本研究。患者人口统计学，动脉瘤特征，FD,颈动脉解剖,围手术期并发症,出院改良Rankin量表（MRS）评分，通过比较有和没有FD尾部贴壁不良的患者来调查随访结果。对连续变量进行t检验或Kruskal-Wallis检验，对分类变量进行Pearsonχ2或Fisher精确检验。进行Logistic回归以确定贴壁不良的预测因素。
■161个FD中有41个发生了尾部贴壁不良（25.5％）。单因素分析表明，FD品牌，FD长度,FD远端与近端血管直径比，FD尾部位置（直的或弯曲的），和血管曲线的曲率与FD尾部贴壁不良显着相关（p<0.05）。进一步的多变量分析表明，超越FD的应用(p=0.04)，FD远端与近端血管直径比（p=0.022），FD尾部位置(直线或曲线)(p<0.001)和血管曲线曲率(p<0.001)是与FD尾部贴壁不良显著相关的因素。在围手术期或随访结果中没有发现显着差异。从成像确定FD尾部贴壁不良的分类。FD尾部贴壁不良的两种主要模式是未附着的尾部和突出的尾部。
■FD尾部贴壁不良可能与远端到近端血管直径差异较大有关，FD尾巴所在的弯曲血管，和血管曲线的较大曲率。FD尾部贴壁不良可分为未附着尾部和突出尾部。各有特点,在临床实践中应注意。
■从我们中心的数据库中回顾性收集了在2020年至2023年之间在颈动脉中有161个FD部署的153例患者，用于本研究。患者人口统计学，动脉瘤特征，FD,颈动脉解剖,围手术期并发症,出院改良Rankin量表（MRS）评分，通过比较有和没有FD尾部贴壁不良的患者来调查随访结果。对连续变量进行t检验或Kruskal-Wallis检验，对分类变量进行Pearsonχ2或Fisher精确检验。进行Logistic回归以确定贴壁不良的预测因素。
■161个FD中有41个发生了尾部贴壁不良（25.5％）。单因素分析表明，FD品牌，FD长度,FD远端与近端血管直径比，FD尾部位置（直的或弯曲的），和血管曲线的曲率与FD尾部贴壁不良显着相关（p<0.05）。进一步的多变量分析表明，超越FD的应用(p=0.04)，FD远端与近端血管直径比（p=0.022），FD尾部位置(直线或曲线)(p<0.001)和血管曲线曲率(p<0.001)是与FD尾部贴壁不良显著相关的因素。在围手术期或随访结果中没有发现显着差异。从成像确定FD尾部贴壁不良的分类。FD尾部贴壁不良的两种主要模式是未附着的尾部和突出的尾部。
■FD尾部贴壁不良可能与远端到近端血管直径差异较大有关，FD尾巴所在的弯曲血管，和血管曲线的较大曲率。FD尾部贴壁不良可分为未附着尾部和突出尾部。各有特点,在临床实践中应注意。
