Flow diversion for acutely ruptured intracranial aneurysms: A single-center retrospective analysis of 30 consecutive cases.

IF 2.3 4区 医学 Q3 CLINICAL NEUROLOGY
Brain Circulation Pub Date : 2025-04-09 eCollection Date: 2025-04-01 DOI:10.4103/bc.bc_132_24
Arevik Abramyan, Mena Samaan, Kaustav Chattopadhyay, Siddhant Kumarapuram, Srihari Sundararajan, Hai Sun, Emad Nourollah-Zadeh, Sudipta Roychowdhury, Gaurav Gupta
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引用次数: 0

Abstract

Objectives: When presented with acutely ruptured aneurysms, neurosurgeons may elect to use flow diverters (FDs). However, with the limited evidence concerning their safety and the potential thromboembolic and hemorrhagic complications, their use is extremely infrequent and often quite limited. In this study, we evaluated treatment-related complications, as well as clinical and radiological outcomes, in patients treated with FD stents for acutely ruptured intracranial aneurysms.

Materials and methods: We conducted a retrospective review of patients treated with FDs within 15 days postsubarachnoid hemorrhage from 2012 to 2024. Patient demographics, aneurysm characteristics, procedural specifics, along with clinical and imaging follow-ups were assessed.

Results: The study included 30 patients with a mean age of 55.6 years. Most aneurysms were located within the anterior circulation and were either small or medium-sized. Morphologically, aneurysms were saccular (43.3%), blister-like (40%), and fusiform/dissecting (16.7%). The mean time from rupture onset to treatment was 4.4 days. FD release was successfully achieved in all cases. Posttreatment rebleeding occurred in 10% of patients, ischemic complications in 6.7%, and treatment-related mortality was 6.6%, with an overall mortality of 13.3%. At discharge, 70% of patients achieved a favorable functional outcome. The mean available radiological follow-up period was 26 months, with complete aneurysm occlusion observed in 57.1% of patients at 1 month and in 100% of those available (40%) for follow-up after 1 year.

Conclusions: Flow diversion for acutely ruptured aneurysms demonstrates promising outcomes, although careful patient selection and alternative treatment consideration are essential. Future prospective, multicenter studies are needed to validate preliminary findings and optimize treatment protocols for this high-risk patient population.

分流治疗急性颅内动脉瘤破裂:连续30例单中心回顾性分析。
目的:当出现急性动脉瘤破裂时,神经外科医生可能会选择使用血流分流器(fd)。然而,关于其安全性和潜在的血栓栓塞和出血并发症的证据有限,它们的使用极为罕见,而且往往相当有限。在这项研究中,我们评估了使用FD支架治疗急性破裂颅内动脉瘤患者的治疗相关并发症以及临床和放射学结果。材料和方法:我们对2012年至2024年蛛网膜下腔出血后15天内接受FDs治疗的患者进行了回顾性分析。评估患者的人口统计学特征、动脉瘤特征、手术细节以及临床和影像学随访。结果:本研究纳入30例患者,平均年龄55.6岁。大多数动脉瘤位于前循环内,大小不一。形态学上,动脉瘤为囊状(43.3%)、水疱样(40%)和梭状/夹层(16.7%)。从破裂到治疗的平均时间为4.4天。所有病例均成功释放FD。治疗后再出血发生率为10%,缺血性并发症发生率为6.7%,治疗相关死亡率为6.6%,总死亡率为13.3%。出院时,70%的患者获得了良好的功能预后。平均放射学随访时间为26个月,1个月时57.1%的患者观察到完全的动脉瘤闭塞,1年后随访的患者100%(40%)观察到完全的动脉瘤闭塞。结论:尽管谨慎的患者选择和替代治疗的考虑是必要的,但对于急性破裂动脉瘤的分流治疗显示出良好的结果。未来需要前瞻性的多中心研究来验证初步发现并优化这一高危患者群体的治疗方案。
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
Brain Circulation
Brain Circulation Multiple-
自引率
5.30%
发文量
31
审稿时长
16 weeks
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