Pipeline embolization in patients with hemoglobinopathies: A cohort study.

IF 1.5 4区 医学 Q4 CLINICAL NEUROLOGY
Eric A Grin, Vera Sharashidze, Maksim Shapiro, Daniel D Wiggan, Eleanor Gutstadt, Charlotte Chung, Adhith Palla, Svetlana Kvint, Jacob Baranoski, Caleb Rutledge, Howard A Riina, Peter Kim Nelson, Erez Nossek, Eytan Raz
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引用次数: 0

Abstract

IntroductionFlow diversion with the pipeline embolization device (PED) is an effective endovascular treatment. However, the metal surface's thrombogenicity and need for dual antiplatelet therapy (DAPT) are notable limitations. Few prior studies have reported specifically on flow diverters' safety in patients with hemoglobinopathies, a population at increased risk of thrombotic and hemorrhagic complications.MethodsNatural language processing queried our institution's medical records for intracranial embolization procedures from 2014 to 2024, screening for "hemoglobinopathy," "thalassemia," and "sickle cell." Patient charts were retrospectively reviewed.ResultsSixteen procedures in 14 patients were identified in which a mean 2.0 PEDs per patient were used. Most patients were female (71.4%). Median age was 48.8 years. Five patients had sickle cell disease, two had sickle cell trait, two had sickle cell or hemoglobin C trait and alpha thalassemia minor, and five had alpha thalassemia minor. The 14 patients were treated for 20 aneurysms; four treatments covered two distinct aneurysms. Median dome size per treatment was 4.0 mm. Of the 16 aneurysm treatments, five (31.2%) treated an irregular aneurysm. Most (56.2%) treatments used multiple PEDs. All patients were discharged on DAPT after verifying effect with P2Y12 assays. Follow-up DSA, CTA, or MRA was obtained in 12/14 (85.7%) patients at a median 1.6 years. Complete occlusion was achieved in all aneurysms. Clinical follow-up was obtained in all patients at a median 2.2 years. There were no thromboembolic or hemorrhagic complications, neurological deficits, or mortalities.ConclusionPipeline embolization can safely and effectively treat patients with hemoglobinopathies.

血红蛋白病患者的管道栓塞:一项队列研究。
采用管道栓塞装置(PED)分流是一种有效的血管内治疗方法。然而,金属表面的血栓形成性和需要双重抗血小板治疗(DAPT)是显着的局限性。很少有先前的研究专门报道了血流分流器在血红蛋白病患者中的安全性,血红蛋白病患者是血栓和出血性并发症风险增加的人群。方法采用自然语言处理查询我院2014 - 2024年颅内栓塞手术的病历,筛查“血红蛋白病”、“地中海贫血”和“镰状细胞”。回顾性回顾患者病历。结果在14例患者中确定了16种手术,平均每位患者使用了2.0个ped。大多数患者为女性(71.4%)。中位年龄为48.8岁。5例患者有镰状细胞病,2例患者有镰状细胞特征,2例患者有镰状细胞或血红蛋白C特征和α -轻微地中海贫血,5例患者有α -轻微地中海贫血。14例患者共治疗20个动脉瘤;四种治疗方法覆盖了两个不同的动脉瘤。每次治疗的中位圆顶大小为4.0 mm。在16例动脉瘤治疗中,5例(31.2%)治疗了不规则动脉瘤。大多数(56.2%)治疗使用多个ped。P2Y12检测验证效果后,所有患者均予DAPT出院。12/14(85.7%)患者随访DSA、CTA或MRA,中位随访时间为1.6年。所有动脉瘤均被完全闭塞。所有患者的临床随访时间中位数为2.2年。没有血栓栓塞或出血性并发症、神经功能缺损或死亡。结论管道栓塞治疗血红蛋白病安全有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Interventional Neuroradiology
Interventional Neuroradiology CLINICAL NEUROLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
3.60
自引率
11.80%
发文量
192
审稿时长
6-12 weeks
期刊介绍: Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...
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