Y-stent-assisted coiling with pEGASUS stents for intracranial bifurcation aneurysms: A multi-center retrospective study.

IF 2.1 4区 医学 Q4 CLINICAL NEUROLOGY
Abdallah Aburub, Ali Khanafer, Zakarya Ali, Mohammad Almohammad, Oussama Dob, Mete Dadak, Lars Timmermann, Ole Simon, Anja Gerstner, Mariana Gurschi, Yashar Aghazadeh, Christopher Nimsky, Benjamin Saß, Hans Henkes, André Kemmling, Stephan Felber
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引用次数: 0

Abstract

ObjectivesY-stent-assisted coiling (Y-SAC) is an established technique for managing wide-necked intracranial bifurcation aneurysms. However, data on the use of the pEGASUS stent, a self-expanding open-cell stent with an antithrombogenic hydrophilic polymer coating, remain limited. This study evaluated the effectiveness and safety of Y-SAC with pEGASUS stents in patients with intracranial bifurcation aneurysms.MethodsThis retrospective observational study included patients treated with Y-SAC with pEGASUS stents at six neurovascular centers between July 2021 and June 2024. Data on aneurysm characteristics, procedural details, and clinical outcomes were collected. Aneurysm occlusion was assessed with the modified Raymond-Roy classification (MRRC) at 6 and 12 months. The primary endpoint was complete aneurysm occlusion (MRRC I), whereas secondary endpoints included perioperative complications, functional outcomes, and retreatment rates.ResultsA total of 40 patients (mean age: 61.6 ± 9.4 years; 60% women) were included. Immediately post-procedure, 100% of aneurysms achieved complete occlusion (MRRC I). At 6-12 months follow-up, 92.5% maintained MRRC I occlusion, and 2.5% exhibited neck remnants (MRRC II). Functional outcomes were favorable in 95% of patients at discharge. The overall complication rate was 4.8%, and one patient (2.5%) required retreatment. No periprocedural thromboembolic events were observed.ConclusionsOur findings indicated that Y-SAC with pEGASUS stents achieves high rates of durable aneurysm occlusion with minimal complications, thus supporting its use as a safe and effective strategy for wide-necked bifurcation aneurysms. Future prospective studies are needed to validate long-term outcomes and optimize treatment strategies.

y支架辅助盘绕pEGASUS支架治疗颅内分岔动脉瘤:一项多中心回顾性研究。
目的:支架辅助盘绕术(Y-SAC)是治疗颅内宽颈分岔动脉瘤的一种成熟技术。然而,pEGASUS支架的使用数据仍然有限,pEGASUS支架是一种具有抗血栓亲水性聚合物涂层的自膨胀开孔支架。本研究评估Y-SAC联合pEGASUS支架治疗颅内分岔动脉瘤的有效性和安全性。方法本回顾性观察研究纳入了2021年7月至2024年6月在6个神经血管中心接受Y-SAC联合pEGASUS支架治疗的患者。收集了动脉瘤特征、手术细节和临床结果的数据。在6个月和12个月时采用改良的Raymond-Roy分级(MRRC)评估动脉瘤闭塞。主要终点是动脉瘤完全闭塞(MRRC I),而次要终点包括围手术期并发症、功能结局和再治疗率。结果共40例患者,平均年龄:61.6±9.4岁;(60%为女性)。手术后,100%的动脉瘤实现了完全闭塞(MRRC I)。在6-12个月的随访中,92.5%的患者维持MRRC I闭塞,2.5%的患者出现颈部残留(MRRC II)。95%的患者出院时功能预后良好。总并发症发生率为4.8%,1例(2.5%)患者需要再治疗。未观察到围手术期血栓栓塞事件。结论Y-SAC联合pEGASUS支架可获得高的持久动脉瘤闭塞率和最小的并发症,因此支持其作为一种安全有效的治疗宽颈分叉动脉瘤的策略。未来的前瞻性研究需要验证长期结果和优化治疗策略。
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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