摘要
目的探讨Pipeline血流导向装置(PED)Shield治疗颅内未破裂囊性动脉瘤的安全性及有效性。方法本研究为回顾性病例系列研究,选择自2023年7月至2024年10月于南方医科大学珠江医院神经外科中心脑血管病外科接受PED Shield治疗的124例颅内未破裂囊性动脉瘤患者为研究对象。统计患者术中器械相关并发症、术后30 d内出血性或缺血性并发症发生情况,以及患者术后6个月时临床随访及影像学随访结果(包括支架内血流通畅程度及动脉瘤闭塞情况),其中临床随访以改良Rankin量表(mRS)评分>2分为预后不良,影像学随访以O'Kelly Marotta(OKM)分级D级为动脉瘤完全闭塞。结果124例患者中,术中器械相关并发症发生率为6.5%(8/124),术后30 d内缺血性并发症发生率为4.8%(6/124)、出血性并发症发生率为1.6%(2/124)。84例患者完成术后6个月的临床随访,其中预后不良患者1例(1.2%)。84例患者完成术后6个月的影像学随访,其中动脉瘤完全闭塞率为82.1%(69/84),支架内狭窄(狭窄程度≥25%)发生率为4.8%(4/84),未发现症状性支架内狭窄。结论本研究数据显示PED Shield治疗颅内未破裂囊性动脉瘤安全、有效。
Objective To investigate the safety and efficacy of Pipeline embolization device(PED)Shield in intracranial unruptured saccular aneurysms.Methods This is a retrospective cohort study;124 patients with intracranial unruptured saccular aneurysms treated with PED Shield at Department of Cerebrovascular Surgery,Neurosurgery Center,Zhujiang Hospital,Southern Medical University from July 2023 to October 2024 were enrolled.Intraoperative device-related complications and occurrence of hemorrhagic and ischemic complications within 30 days of the procedure were recorded.The clinical results and imaging results(degrees of stent patency and aneurysm occlusion rate)6 months after follow-up were statistically analyzed.Modified Rankin scale(mRS)score>2 was defined as poor prognosis in clinical follow-up,and grade D according to O'Kelly Marotta(OKM)classification was considered as complete aneurysm occlusion in imaging follow-up.Results Eighty-seven females and 37 males,aged(56.44±12.17)years(ranging from 27 to 80 years)were enrolled,with a maximum aneurysm diameter of 5.12(3.73,7.24)mm.Among the 124 patients,incidence of intraoperative instrument-related complications was 6.5%(8/124);and within 30 days of the procedure,incidence of ischemic complications was 4.8%(6/124)and that of hemorrhagic complications was 1.6%(2/124).Eighty-four patients had a 6-month clinical follow-up,with 1 patient(1.2%)having poor prognosis.Eighty-four patients(67.7%)completed a 6-month imaging follow-up:complete occlusion rate of aneurysms was 82.1%(69/84),incidence of in-stent stenosis(stenosis degree≥25%)was 4.8%(4/84),and no symptomatic in-stent stenosis was found.Conclusion Result of this study shows that PED Shield may be an effective and safe clinical option for intracranial unruptured saccular aneurysms.
作者
葛润泽
冯欣
邓雪妍
谢泽惠
李灿
梁淑茵
苏世星
张炘
李西锋
段传志
Ge Runze;Feng Xin;Deng Xueyan;Xie Zehui;Li Can;Liang Shuyin;Su Shixing;Zhang Xin;Li Xifeng;Duan Chuanzhi(National Key Clinical Specialty,Engineering Research Center of Diagnostic and Therapeutic Technology and Devices for Cerebrovascular Diseases in Ministry of Education,Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration,Institute for Brain Science and Intelligence in Zhujiang Hospital,Department of Cerebrovascular Surgery,Neurosurgery Center,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China;Second Clinical Medical School,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China)
出处
《中华神经医学杂志》
北大核心
2025年第7期649-655,共7页
Chinese Journal of Neuromedicine
基金
国家自然科学基金(82201427)
国家卫生健康委能力建设和继续教育中心课题(GWJJ2022100102、GWJJQ2022100104、GWJJQ2023100101)。
