目的:尽管手术夹闭颈内动脉(ICA)的手术成功率相对较高,流动转向器(FD)支架治疗越来越多地用于这些动脉瘤。本研究旨在评估Türkiye6个不同经验水平的不同中心未破裂的ICA上样段动脉瘤的FD放置特征。
方法:在本回顾性研究中,多中心研究,作者回顾了人口统计信息,动脉瘤形状/尺寸(颈部,纵横比,圆顶/颈部比,和最大直径),术前抗血小板方案,FD支架品牌,围手术期并发症,干预时间,临床(改良Rankin量表)和放射学(O'Kelly-Marotta[OKM]分级量表)结果,54例患者的随访时间。
结果:在纳入研究的54例患者中,共对61个动脉瘤(58个股上ICA动脉瘤)进行了55次干预。该人群的男女比例为44/10,平均年龄为53.5±13.6(范围21-82)岁。动脉瘤最常见的形式和位置是囊状91.4%(53/58)和眼科段69%(40/58),分别。优选的抗血小板方案是乙酰水杨酸+替格瑞洛50%(27/54)。总并发症发生率为25.5%(14/55),平均随访时间为25.76±17.88个月。6个月随访时,成功的放射学结果(OKMC级或D级)率为92.6%。没有围手术期并发症导致任何永久性或短暂性神经功能缺损。
结论:这项首次多中心研究评估了FD支架用于未破裂的ICA上膜段动脉瘤的结果表明,FD支架治疗是一种可行的替代夹闭和弹簧圈栓塞的方法,并发症可控,成功率高。
Despite the relatively high success of surgical clipping of supraclinoid segment aneurysms of the internal carotid artery (ICA), flow diverter (FD) stent therapy is becoming increasingly used for these aneurysms. This study aims to evaluate the characteristics of FD placement for unruptured ICA supraclinoid segment aneurysms at 6 different centers with different experience levels in Türkiye.
In this retrospective, multicenter study, the authors reviewed the demographic information, aneurysm shape/dimensions (neck, aspect ratio, dome/neck ratio, and maximum diameter), preoperative antiplatelet regimen, FD stent brand, perioperative complications, intervention time, clinical (modified Rankin Scale) and radiological (O\'Kelly-Marotta [OKM] grading scale) outcomes, and follow-up time of 54 patients.
A total of 55 interventions for 61 aneurysms (58 supraclinoid ICA aneurysms) were performed in the 54 patients included in the study. The female/male ratio in this population was 44/10, and the mean age was 53.5 ± 13.6 (range 21-82) years. The most common form and location of the aneurysms were saccular 91.4% (53/58) and ophthalmic segment 69% (40/58), respectively. The preferred antiplatelet regimen was acetylsalicylic acid plus ticagrelor 50% (27/54). The overall complication rate was 25.5% (14/55), and the mean follow-up time was 25.76 ± 17.88 months. The successful radiological outcome (OKM grade C or D) rate at the 6-month follow-up was 92.6%. No perioperative complications led to any permanent or transient neurological deficit.
The results of this first multicenter study evaluating FD stent use for unruptured ICA supraclinoid segment aneurysms showed that FD stent treatment is a feasible method for replacing clipping and coil embolization with manageable complications and a high success rate.