Abstract：
Few studies have compared the Pipeline Shield stents with previous generations of flow-diverting stents (FDSs) for the treatment of unruptured intracranial aneurysms. This study aimed to evaluate the efficacy and safety of Pipeline Shield stents and FDSs without modified surfaces.
The present evaluation is a retrospective cohort study of patients endovascularly treated with Pipeline Shield stents or FDSs without modified surfaces for unruptured intracranial aneurysms between January 2014 and June 2022. The data analyzed were obtained from the anonymized database of our institution\'s interventional radiology service.
A total of 147 patients with 155 unruptured intracranial aneurysms were included. Of the 155 aneurysms, 96 were treated with Pipeline Shield stents and 59 with FDSs without modified surfaces. The aneurysms treated with Pipeline Shield stents had higher 6-month (O\'Kelly-Marotta [OKM] D; 87.5% vs. 71.4%; P = 0.025) and 1-year (OKM D; 82.5% vs. 63.0%; P = 0.047) occlusion rates than the aneurysms treated using FDSs without modified surfaces. No differences between the devices were found at the 1-year follow-up in the incidence of ischemic stroke (P = 0.939) or hemorrhagic complications (P = 0.559).
Pipeline Shield stents demonstrated superior complete occlusion rates (OKM D) at both the 6-month and the 1-year follow-up assessments compared with nonmodified surface FDSs. No significant differences were found in the safety profiles between the 2 types of stents with regard to thromboembolic complications and ischemic events. Further research with larger study populations is necessary to validate these findings.
The present evaluation is a retrospective cohort study of patients endovascularly treated with Pipeline Shield stents or FDSs without modified surfaces for unruptured intracranial aneurysms between January 2014 and June 2022. The data analyzed were obtained from the anonymized database of our institution\'s interventional radiology service.
A total of 147 patients with 155 unruptured intracranial aneurysms were included. Of the 155 aneurysms, 96 were treated with Pipeline Shield stents and 59 with FDSs without modified surfaces. The aneurysms treated with Pipeline Shield stents had higher 6-month (O\'Kelly-Marotta [OKM] D; 87.5% vs. 71.4%; P = 0.025) and 1-year (OKM D; 82.5% vs. 63.0%; P = 0.047) occlusion rates than the aneurysms treated using FDSs without modified surfaces. No differences between the devices were found at the 1-year follow-up in the incidence of ischemic stroke (P = 0.939) or hemorrhagic complications (P = 0.559).
Pipeline Shield stents demonstrated superior complete occlusion rates (OKM D) at both the 6-month and the 1-year follow-up assessments compared with nonmodified surface FDSs. No significant differences were found in the safety profiles between the 2 types of stents with regard to thromboembolic complications and ischemic events. Further research with larger study populations is necessary to validate these findings.
摘要：
背景：很少有研究将PipelineShield支架与前几代分流支架（FD）进行比较，以治疗未破裂的颅内动脉瘤（UIA）。本研究旨在评估没有改性表面的管道屏蔽支架和FD的有效性和安全性。
方法：本评估是对2014年1月至2022年6月期间使用PipelineShield支架或无改良表面的分流（FD）支架进行血管内治疗的患者的回顾性队列研究。分析的数据是从该机构的介入放射学服务的匿名数据库获得的。
结果：纳入147例患者，155例UIA。其中96个用PipelineShield支架处理，59个用FD处理，没有表面改性。使用PipelineShield支架治疗的动脉瘤在六个月内较高（OKMD;87.5％vs.71.4%,p值：0.025）和一年期（OKMD；82.5%与63.0%,p值：0.047）闭塞率高于使用未修饰表面的FD治疗的动脉瘤。在缺血性中风（p值：0.939）和出血性并发症（p值：0.559）的一年随访中，设备之间没有差异。
结论：PipelineShield支架在6个月和1年的随访评估中，与未修饰的表面FD相比，显示出较高的完全闭塞率（OKMD）。两种类型的支架在血栓栓塞并发症和缺血事件方面的安全性没有显著差异。有必要对更大的研究人群进行进一步的研究以验证这些发现。
方法：本评估是对2014年1月至2022年6月期间使用PipelineShield支架或无改良表面的分流（FD）支架进行血管内治疗的患者的回顾性队列研究。分析的数据是从该机构的介入放射学服务的匿名数据库获得的。
结果：纳入147例患者，155例UIA。其中96个用PipelineShield支架处理，59个用FD处理，没有表面改性。使用PipelineShield支架治疗的动脉瘤在六个月内较高（OKMD;87.5％vs.71.4%,p值：0.025）和一年期（OKMD；82.5%与63.0%,p值：0.047）闭塞率高于使用未修饰表面的FD治疗的动脉瘤。在缺血性中风（p值：0.939）和出血性并发症（p值：0.559）的一年随访中，设备之间没有差异。
结论：PipelineShield支架在6个月和1年的随访评估中，与未修饰的表面FD相比，显示出较高的完全闭塞率（OKMD）。两种类型的支架在血栓栓塞并发症和缺血事件方面的安全性没有显著差异。有必要对更大的研究人群进行进一步的研究以验证这些发现。
