Predictors of flow diverter stent in large and giant unruptured intracranial aneurysms, single-center experience,Neurological Sciences

当前位置： X-MOL 学术 › Neurol. Sci. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Predictors of flow diverter stent in large and giant unruptured intracranial aneurysms, single-center experience
Neurological Sciences ( IF 2.7 ) Pub Date : 2022-08-19 , DOI: 10.1007/s10072-022-06336-w
Hazem Abdelkhalek ₁ , Esam Ahmed Abdelhameed ₂ , Ayman Zakarea ₃ , Islam El Malky ₄

Affiliation

Background

Flow diversion with or without coiling has been established as the treatment of choice for large unruptured aneurysms. This study aims to assess possible predictors for radiological and clinical outcome such as location of the aneurysm (anterior or posterior circulation), complexity by a branching artery, bifurcation, and adjuvant coiling.

Methods

This study was conducted on 65 consecutive patients with 65 large, unruptured intracranial aneurysms (size ≥ 10 mm) treated with flow diverters. Follow-up angiography was done for 60 patients (92.3%) at 12 ± 8.6 months range from 3 to 36 months.

Results

Complete occlusion was achieved in 50 from 60 aneurysms (83.4%), while 8 aneurysms (13.3%) had neck remnant, and another two aneurysms (3.3%) remained with aneurysmal remnant. Periprocedural complications were encountered in 14 patients (21.5%) with morbidity in six patients (9.2%) and mortality in one patient (1.5%). In a multivariate logistic regression, anterior versus posterior location was less likely associated with worse outcome; adjusted OR (95% CI) of 0.16 (0.07–0.01), p = 0.006. Complete occlusion in complex aneurysms with branching artery was 60% versus 88% in simple aneurysms without branching artery (p-value = 0.04).

Conclusions

Flow diverter deployment of a large, unruptured aneurysm in the anterior circulation might have a better outcome than one in the posterior circulation. Flow diverter of aneurysms with branching artery or at bifurcation might be associated with aneurysm persistence and complications respectively.

中文翻译：

大型和巨型未破裂颅内动脉瘤中分流支架的预测因子，单中心经验

背景

带或不带盘绕的分流已被确定为大型未破裂动脉瘤的首选治疗方法。本研究旨在评估影像学和临床结果的可能预测因素，例如动脉瘤的位置（前循环或后循环）、分支动脉的复杂性、分叉和辅助栓塞。

方法

这项研究是对 65 名连续使用分流器治疗的 65 个未破裂的大型颅内动脉瘤（大小 ≥ 10 mm）的患者进行的。在 3 至 36 个月的 12 ± 8.6 个月内对 60 名患者 (92.3%) 进行了随访血管造影。

结果

60 个动脉瘤中有 50 个（83.4%）完全闭塞，8 个动脉瘤（13.3%）有颈部残余，另外 2 个动脉瘤（3.3%）有残余动脉瘤。14 名患者 (21.5%) 出现围手术期并发症，其中 6 名患者 (9.2%) 发病率和 1 名患者 (1.5%) 死亡率。在多变量逻辑回归中，前部与后部位置不太可能与较差的结果相关；调整后的 OR (95% CI) 为 0.16 (0.07–0.01)，p = 0.006。有分支动脉的复杂动脉瘤的完全闭塞率为 60%，而无分支动脉的简单动脉瘤的完全闭塞率为 88%（p值 = 0.04）。