Shuhai Long, Shuailong Shi, Qi Tian, Zhuangzhuang Wei, Ji Ma, Ye Wang, Jie Yang, Xinwei Han, Tengfei Li
{"title":"颅内小动脉瘤患者动脉瘤颈部血流分流器错位与动脉瘤不完全闭塞的相关性：单中心经验","authors":"Shuhai Long, Shuailong Shi, Qi Tian, Zhuangzhuang Wei, Ji Ma, Ye Wang, Jie Yang, Xinwei Han, Tengfei Li","doi":"10.3174/ajnr.a8079","DOIUrl":null,"url":null,"abstract":"<sec><st>BACKGROUND AND PURPOSE:</st>\n<p>Flow diversion treatment repairs aneurysms by altering the hemodynamics of the aneurysmal sac and providing a scaffold for endothelial cell adhesion. The purpose of this study was to investigate the correlation of flow diverter (FD) malapposition at the aneurysm neck with incomplete occlusion of small intracranial aneurysms (IAs) and investigate other factors that are possibly related to incomplete occlusion.</p>\n</sec>\n<sec><st>MATERIALS AND METHODS:</st>\n<p>From January 2019 to June 2022, the clinical and imaging data for 153 patients (175 aneurysms) with unruptured small IAs treated with flow diversion were retrospectively analyzed. FD apposition at the aneurysm neck was evaluated by high-resolution conebeam CT (HR-CBCT), and the complete occlusion rate for aneurysms was judged according to the latest follow-up conventional angiography findings (≥6 months). Multivariate logistic regression analysis was used to determine factors associated with incomplete aneurysm occlusion.</p>\n</sec>\n<sec><st>RESULTS:</st>\n<p>In total, 159 FDs were implanted in 153 patients. HR-CBCT performed after the deployment revealed FD malapposition at the aneurysm neck in 18 cases. According to the latest follow-up angiograms (average: 9.47 ± 3.35 months), the complete aneurysm occlusion rate was 66.9%. The complete occlusion rates for incomplete and complete stent apposition at the neck were 38.9% (7/18) and 70.1% (110/157), respectively. The results of regression analysis showed that an aneurysm sac with branch vessels (OR, 2.937; <I>P</I> = .018), incomplete stent apposition at the aneurysm neck (OR, 3.561; <I>P</I> = .023), and a large aneurysm diameter (OR, 1.533; <I>P</I> = .028) were positive predictors of incomplete aneurysm occlusion.</p>\n</sec>\n<sec><st>CONCLUSIONS:</st>\n<p>An aneurysm sac with branch vessels, a large aneurysm diameter, and malapposition at the aneurysm neck significantly affect aneurysm repair after FD stent-only treatment for small IAs.</p>\n</sec>","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"27 1","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Correlation of Flow Diverter Malapposition at the Aneurysm Neck with Incomplete Aneurysm Occlusion in Patients with Small Intracranial Aneurysms: A Single-Center Experience\",\"authors\":\"Shuhai Long, Shuailong Shi, Qi Tian, Zhuangzhuang Wei, Ji Ma, Ye Wang, Jie Yang, Xinwei Han, Tengfei Li\",\"doi\":\"10.3174/ajnr.a8079\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<sec><st>BACKGROUND AND PURPOSE:</st>\\n<p>Flow diversion treatment repairs aneurysms by altering the hemodynamics of the aneurysmal sac and providing a scaffold for endothelial cell adhesion. The purpose of this study was to investigate the correlation of flow diverter (FD) malapposition at the aneurysm neck with incomplete occlusion of small intracranial aneurysms (IAs) and investigate other factors that are possibly related to incomplete occlusion.</p>\\n</sec>\\n<sec><st>MATERIALS AND METHODS:</st>\\n<p>From January 2019 to June 2022, the clinical and imaging data for 153 patients (175 aneurysms) with unruptured small IAs treated with flow diversion were retrospectively analyzed. FD apposition at the aneurysm neck was evaluated by high-resolution conebeam CT (HR-CBCT), and the complete occlusion rate for aneurysms was judged according to the latest follow-up conventional angiography findings (≥6 months). Multivariate logistic regression analysis was used to determine factors associated with incomplete aneurysm occlusion.</p>\\n</sec>\\n<sec><st>RESULTS:</st>\\n<p>In total, 159 FDs were implanted in 153 patients. HR-CBCT performed after the deployment revealed FD malapposition at the aneurysm neck in 18 cases. According to the latest follow-up angiograms (average: 9.47 ± 3.35 months), the complete aneurysm occlusion rate was 66.9%. The complete occlusion rates for incomplete and complete stent apposition at the neck were 38.9% (7/18) and 70.1% (110/157), respectively. The results of regression analysis showed that an aneurysm sac with branch vessels (OR, 2.937; <I>P</I> = .018), incomplete stent apposition at the aneurysm neck (OR, 3.561; <I>P</I> = .023), and a large aneurysm diameter (OR, 1.533; <I>P</I> = .028) were positive predictors of incomplete aneurysm occlusion.</p>\\n</sec>\\n<sec><st>CONCLUSIONS:</st>\\n<p>An aneurysm sac with branch vessels, a large aneurysm diameter, and malapposition at the aneurysm neck significantly affect aneurysm repair after FD stent-only treatment for small IAs.</p>\\n</sec>\",\"PeriodicalId\":7875,\"journal\":{\"name\":\"American Journal of Neuroradiology\",\"volume\":\"27 1\",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3174/ajnr.a8079\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3174/ajnr.a8079","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Correlation of Flow Diverter Malapposition at the Aneurysm Neck with Incomplete Aneurysm Occlusion in Patients with Small Intracranial Aneurysms: A Single-Center Experience
BACKGROUND AND PURPOSE:
Flow diversion treatment repairs aneurysms by altering the hemodynamics of the aneurysmal sac and providing a scaffold for endothelial cell adhesion. The purpose of this study was to investigate the correlation of flow diverter (FD) malapposition at the aneurysm neck with incomplete occlusion of small intracranial aneurysms (IAs) and investigate other factors that are possibly related to incomplete occlusion.
MATERIALS AND METHODS:
From January 2019 to June 2022, the clinical and imaging data for 153 patients (175 aneurysms) with unruptured small IAs treated with flow diversion were retrospectively analyzed. FD apposition at the aneurysm neck was evaluated by high-resolution conebeam CT (HR-CBCT), and the complete occlusion rate for aneurysms was judged according to the latest follow-up conventional angiography findings (≥6 months). Multivariate logistic regression analysis was used to determine factors associated with incomplete aneurysm occlusion.
RESULTS:
In total, 159 FDs were implanted in 153 patients. HR-CBCT performed after the deployment revealed FD malapposition at the aneurysm neck in 18 cases. According to the latest follow-up angiograms (average: 9.47 ± 3.35 months), the complete aneurysm occlusion rate was 66.9%. The complete occlusion rates for incomplete and complete stent apposition at the neck were 38.9% (7/18) and 70.1% (110/157), respectively. The results of regression analysis showed that an aneurysm sac with branch vessels (OR, 2.937; P = .018), incomplete stent apposition at the aneurysm neck (OR, 3.561; P = .023), and a large aneurysm diameter (OR, 1.533; P = .028) were positive predictors of incomplete aneurysm occlusion.
CONCLUSIONS:
An aneurysm sac with branch vessels, a large aneurysm diameter, and malapposition at the aneurysm neck significantly affect aneurysm repair after FD stent-only treatment for small IAs.
期刊介绍：
The mission of AJNR is to further knowledge in all aspects of neuroimaging, head and neck imaging, and spine imaging for neuroradiologists, radiologists, trainees, scientists, and associated professionals through print and/or electronic publication of quality peer-reviewed articles that lead to the highest standards in patient care, research, and education and to promote discussion of these and other issues through its electronic activities.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
