使用双重叠支架对急性颅内椎动脉夹层动脉瘤进行血管内治疗的临床和血管造影结果 :企业支架内的低调可视化腔内支撑。

IF 1.4 4区 医学 Q4 CLINICAL NEUROLOGY
Journal of Korean Neurosurgical Society Pub Date : 2024-08-01 Epub Date: 2023-12-22 DOI:10.3340/jkns.2023.0224
Ja Ho Koo, Eui Hyun Hwang, Ji Hye Song, Yong Cheol Lim
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引用次数: 0

摘要

目的:在目前治疗颅内椎动脉夹层动脉瘤(VADA)的方法中,使用双重叠支架进行重建治疗已被证明是有效且安全的。我们采用了重叠支架组合,在 Enterprise 支架内使用低调的可视腔内支撑(LVIS)。选择这种组合是为了在保持血流分流和稳定性的同时,通过与 Enterprise 支架重叠,最大限度地减少 LVIS 内部的外凸。本研究旨在评估在Enterprise支架内使用带LVIS的双重叠支架治疗VADAs后的临床和血管造影结果:方法:2016年3月至2022年1月,我院共对28例未破裂的VADA患者进行了企业支架内LVIS双重叠支架技术治疗。首先部署Enterprise支架,然后部署LVIS支架。对患者的临床和血管造影特征、手术并发症和随访结果进行了回顾性分析:结果:所有28名患者(18男10女)均成功接受了双重叠支架置入术。所有患者均未出现手术并发症或新的神经功能缺损。在28名患者中,有4名患者的小脑后下动脉受累。在术后6至12个月的血管造影随访中,没有发生与手术相关的母动脉闭塞。在 28 名患者中,24 人完全愈合,3 人有局灶性残余狭窄或扩张并伴有残囊,只有 1 人有带动脉瘤的残余剥离瓣。包括这四名患者在内的所有患者都无需进行任何其他手术。所有患者的术后改良Rankin量表(mRS)评分均为0-1分:结论:具有血流分流作用的双层重叠支架是治疗 VADA 患者的一种安全有效的方法。尤其是在企业支架内使用 LVIS 支架时,可最大限度地减少 LVIS 内支架的隆起,同时保持血流分流和稳定性。因此,这两种支架可作为重叠支架有效使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical and Angiographic Outcomes of Endovascular Treatment for Acute Intracranial Vertebral Artery Dissecting Aneurysms Using Double-Overlapping Stents : Low-Profile Visualized Intraluminal Support within Enterprise Stents.

Objective: The use of reconstructive treatment with a double-overlapping stents has proven to be effective and safe in the current treatment of intracranial vertebral artery dissecting aneurysms (VADAs). We employed a combination of overlapping stents, using low-profile visualized intraluminal support (LVIS) within the Enterprise stent. This combination was chosen to minimize the outward bulging of the inner LVIS by overlapping it with the Enterprise stent while maintaining flow diversion and stability. This study aimed to evaluate the clinical and angiographic outcomes following the use of double-overlapping stents with LVIS within the Enterprise stent for the treatment of VADAs.

Methods: From March 2016 to January 2022, total 28 patients with unruptured VADAs were treated with the double-overlapping stent technique using LVIS within an Enterprise stent in our institute. The Enterprise stent was deployed first, followed by the LVIS stent. Patient clinical and angiographic characteristics, procedural complications, and follow-up outcomes were retrospectively reviewed.

Results: All 28 patients (18 males and 10 females) were successfully treated with double-overlapping stent deployment. There were no procedural complications or new neurological deficits in any patient. Of the 28 patients, four VADAs had posterior inferior cerebellar artery involvement. Procedure-related parent artery occlusion did not occur during the angiographic follow-up conducted 6 to 12 months after the procedure. Out of 28 patients, 24 showed complete healing, three had focal residual stenosis or dilatation with residual sac and only one had a residual dissecting flap with aneurysm. All patients, including the four patients, did not require any additional procedures. The postoperative modified Rankin scale scores were 0-1 for all patients.

Conclusion: A double-overlapping stent, with a flow-diversion effect, is a safe and effective treatment for patients with VADAs. In particular, when using the LVIS stent within an Enterprise stent, it minimizes the bulging of the inner LVIS stent while maintaining flow diversion and stability. Therefore, both can be effectively utilized as overlapping stents.

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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
109
审稿时长
3-8 weeks
期刊介绍: The Journal of Korean Neurosurgical Society (J Korean Neurosurg Soc) is the official journal of the Korean Neurosurgical Society, and published bimonthly (1st day of January, March, May, July, September, and November). It launched in October 31, 1972 with Volume 1 and Number 1. J Korean Neurosurg Soc aims to allow neurosurgeons from around the world to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism. This journal publishes Laboratory Investigations, Clinical Articles, Review Articles, Case Reports, Technical Notes, and Letters to the Editor. Our field of interest involves clinical neurosurgery (cerebrovascular disease, neuro-oncology, skull base neurosurgery, spine, pediatric neurosurgery, functional neurosurgery, epilepsy, neuro-trauma, and peripheral nerve disease) and laboratory work in neuroscience.
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