Acta neurochirurgica · 2024
Treatment of unruptured intracranial vertebral artery dissection aneurysms with Flow Diverter compared with conventional stent-assisted coiling-a single-center study.
Сравнительное исследованиеСтатьяНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Zhang Tongfu, Zhong Weiying, Zhou Donglin, Xu Yangyang, Li Maogui, Zhuang Jianfeng, Wang Donghai, Su Wandong, Wang Yunyan
Аннотация
AIM: Flow diverters (FDs) are being increasingly used off-label for treatment of intracranial vertebral artery dissection aneurysms (IVADAs). However, the safety and efficacy of FDs for unruptured IVADAs remain unclear. This study was performed to investigate whether FDs-alone are safer and more effective than conventional stent-asisted coiling.
METHODS: We retrospectively analyzed 152 patients who underwent endovascular stenting from December 2011 to December 2022. The baseline data, aneurysm characteristics, surgical details, perioperative complications, follow-up angiography, and clinical outcomes were collected and compared between patients who underwent stenting with FD-alone versus conventional stent-asisted coiling. Propensity score matching was also conducted.
RESULTS: All 152 patients underwent successful endovascular therapy. Forty patients were treated with FDs-alone, and 112 were treated with conventional stent-asisted coiling (including 62 with double stents). The complete occlusion rate was 93.75% in the FD group and 93.61% in the conventional stent group (p = 0.979). The complication rate was 5.00% in the FD group and 8.93% in the conventional stent group (p = 0.653). The in-stent restenosis rate was 3.13% in the FD group and 5.32% in the conventional stent group (p = 0.615). The procedure duration was significantly shorter in the FD than conventional stent group (p = 0.034). After propensity score matching, 37 patients with FDs were successfully matched, and the procedure duration was still significantly shorter in the FD group (p = 0.042).
CONCLUSION: FD placement is a safe and effective treatment for IVADAs. It is also a simpler procedure with a shorter operation time than conventional stent placement.
TRIAL REGISTRATION NUMBER: ChiCTR2300074171 ClinicalTrials.gov ID:NCT06134557.
METHODS: We retrospectively analyzed 152 patients who underwent endovascular stenting from December 2011 to December 2022. The baseline data, aneurysm characteristics, surgical details, perioperative complications, follow-up angiography, and clinical outcomes were collected and compared between patients who underwent stenting with FD-alone versus conventional stent-asisted coiling. Propensity score matching was also conducted.
RESULTS: All 152 patients underwent successful endovascular therapy. Forty patients were treated with FDs-alone, and 112 were treated with conventional stent-asisted coiling (including 62 with double stents). The complete occlusion rate was 93.75% in the FD group and 93.61% in the conventional stent group (p = 0.979). The complication rate was 5.00% in the FD group and 8.93% in the conventional stent group (p = 0.653). The in-stent restenosis rate was 3.13% in the FD group and 5.32% in the conventional stent group (p = 0.615). The procedure duration was significantly shorter in the FD than conventional stent group (p = 0.034). After propensity score matching, 37 patients with FDs were successfully matched, and the procedure duration was still significantly shorter in the FD group (p = 0.042).
CONCLUSION: FD placement is a safe and effective treatment for IVADAs. It is also a simpler procedure with a shorter operation time than conventional stent placement.
TRIAL REGISTRATION NUMBER: ChiCTR2300074171 ClinicalTrials.gov ID:NCT06134557.