Comparative Efficacy of Flow Diverter Devices in the Treatment of Carotid Sidewall Intracranial Aneurysms: a Retrospective, Multicenter Study

被引：5

作者：

Dmytriw, Adam A. ^{[1
,2
,3
,36
,37
,38
]}

Salim, Hamza Adel ^{[3
,4
,39
]}

Musmar, Basel ^{[5
]}

Cancelliere, Nicole M. ^{[6
]}

Griessenauer, Christoph J. ^{[7
]}

Regenhardt, Robert W. ^{[8
,9
]}

Jones, Jesse ^{[10
,11
]}

Tutino, Vincent ^{[10
]}

Hasan, Zuha ^{[1
,2
]}

Limbucci, Nicola ^{[12
,13
]}

Lay, Sovann V. ^{[11
]}

Spears, Julian ^{[1
,2
]}

Rabinov, James D. ^{[8
]}

Harrigan, Mark R. ^{[1
,2
]}

Siddiqui, Adnan H. ^{[10
]}

Levy, Elad I. ^{[10
]}

Stapleton, Christopher J. ^{[8
,9
]}

Renieri, Leonardo ^{[12
]}

Cognard, Christophe ^{[14
]}

Shaikh, Hamza ^{[15
]}

Kuhn, Anna Luisa ^{[15
]}

Moehlenbruch, Markus A. ^{[16
]}

Tjoumakaris, Stavropoula I. ^{[17
]}

Jabbour, Pascal ^{[18
]}

Taussky, Philipp ^{[19
]}

Settecase, Fabio ^{[20
]}

Heran, Manraj K. S. ^{[20
]}

Nguyen, Anh ^{[21
]}

Volders, David ^{[22
,23
]}

Harker, Pablo ^{[24
]}

Devia, Diego A. ^{[25
]}

Puri, Ajit S. ^{[26
]}

Psychogios, Marios ^{[21
]}

Puentes, Juan C. ^{[25
]}

Leone, Giuseppe ^{[27
,28
]}

Buono, Giuseppe ^{[28
]}

Tarantino, Margherita ^{[28
]}

Muto, Mario ^{[27
]}

Briganti, Francesco ^{[27
]}

Dalal, Shamsher ^{[29
,30
]}

Gontu, Vamsi ^{[31
,32
]}

Alcedo Guardia, Rodolfo E. ^{[33
]}

Vicenty-Padilla, Juan C. ^{[33
]}

Brouwer, Patrick ^{[31
,32
]}

Schmidt, Matthias H. ^{[22
,23
]}

Schirmer, Clemens ^{[29
,30
]}

Pickett, Gwynedd E. ^{[22
,23
]}

Andersson, Tommy ^{[31
,32
]}

Soderman, Michael ^{[31
,32
]}

Marotta, Thomas R. ^{[18
]}

机构：

[1] St Michaels Hosp, Neurovasc Ctr, Dept Med Imaging, Toronto, ON, Canada

[2] St Michaels Hosp, Neurovasc Ctr, Dept Neurosurg, Toronto, ON, Canada

[3] Harvard Univ, Massachusetts Gen Hosp, Neuroendovasc Program, Boston, MA 02115 USA

[4] Johns Hopkins Med Ctr, Dept Radiol, Div Neuroradiol, Baltimore, MD 21287 USA

[5] Louisiana State Univ, Dept Neurosurg & Intervent Neuroradiol, Baton Rouge, LA USA

[6] St Michaels Hosp, Dept Neuroradiol, Toronto, ON, Canada

[7] Christian Doppler Univ, Dept Neurosurg, Hosp & Inst Neurointervent, Salzburg, Austria

[8] Massachusetts Gen Hosp, Dept Neuroradiol, Boston, MA USA

[9] Brigham & Womens Hosp, Boston, MA USA

[10] Univ Alabama Birmingham, Dept Neurosurg, Birmingham, AL USA

[11] Univ Alabama Birmingham, Dept Radiol, Birmingham, AL USA

[12] NewYork Presbyterian Hosp, Dept Neurosurg & Neuroradiol, New York, NY USA

[13] Weill Cornell Sch Med, New York, NY USA

[14] Univ Hosp Purpan, Dept Diagnost & Therapeut Neuroradiol, Toulouse, France

[15] Clin Hosp Ctr Sisters Mercy, Dept Neurosurg, Zagreb, Croatia

[16] Univ Klinikum Heidelberg, Sekt Vaskulare & Intervent Neuroradiol, Heidelberg, Germany

[17] Thomas Jefferson Univ Hosp, Dept Neurosurg, Philadelphia, PA USA

[18] Thomas Jefferson Univ, Dept Neurosurg, Philadelphia, PA USA

[19] Univ Utah, Clin Neurosci Ctr, Dept Neurosurg, Salt Lake City, UT USA

[20] Univ British Columbia, Vancouver Gen Hosp, Div Neuroradiol, Vancouver, BC, Canada

[21] Univ Hosp Basel, Dept Neuroradiol, Basel, Switzerland

[22] Dalhousie Med Sch, QEII Hlth Sci Ctr, Div Neuroradiol, Halifax, NS, Canada

[23] Dalhousie Med Sch, QEII Hlth Sci Ctr, Div Neurosurg, Halifax, NS, Canada

[24] Univ Cincinnati, Med Ctr, Dept Neurol, Cincinnati, OH USA

[25] Pontificia Univ Javeriana, Hosp Univ San Ignacio, Sch Med Bogota, Bogota, Colombia

[26] UMass Mem Hosp, Dept Neuroradiol, Worcester, MA USA

[27] AORN Antonio Cardarelli Hosp, Dept Adv Diagnost & Therapeut Technol, Unit Intervent Neuroradiol, Via Cardarelli 1, Naples, Italy

[28] Univ Naples Federico II, Dept Adv Biomed Sci, Unit Intervent Neuroradiol, Naples, Italy

[29] Geisinger Hosp, Dept Neurosurg, Danville, PA USA

[30] Geisinger Hosp, Dept Radiol, Danville, PA USA

[31] Karolinska Univ Hosp, Dept Neuroradiol, Stockholm, Sweden

[32] Karolinska Univ Hosp, Dept Neurosurg, Stockholm, Sweden

[33] Univ Puerto Rico, Sch Med, Dept Neurosurg, San Juan, PR USA

[34] Mayo Clin, Dept Neurol Surg, Rochester, MN USA

[35] Mayo Clin, Dept Radiol, Rochester, MN USA

[36] Univ Toronto, St Michaels Hosp, Dept Radiol, Div Diagnost & Therapeut Neuroradiol, Toronto, ON, Canada

[37] Massachusetts Gen Hosp Brigham, Neuroendovasc Program, Boston, MA 02199 USA

[38] Harvard Univ, Womens Hosp, Boston, MA 02115 USA

[39] Johns Hopkins Med Ctr, Dept Radiol, Div Neuroradiol, Baltimore, MD 21287 USA

来源：

CLINICAL NEURORADIOLOGY | 2024年 / 34卷 / 04期

关键词：

Flow Diverter Devices; Intracranial Aneurysms; Thromboembolic Complications; Pipeline Emboliza on Device; Modified Rankin Scale; Hemorrhagic Complications; PIPELINE EMBOLIZATION DEVICE; REDIRECTION ENDOLUMINAL DEVICE; ENDOVASCULAR TREATMENT; CEREBRAL ANEURYSMS; SHORT-TERM; ARTERY ANEURYSMS; SAFETY; STENTS;

D O I：

10.1007/s00062-024-01435-x

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background The comparative efficacy and safety of first-generation flow diverters (FDs), Pipeline Embolization Device (PED) (Medtronic, Irvine, California), Silk (Balt Extrusion, Montmorency, France), Flow Re-direction Endoluminal Device (FRED) (Microvention, Tustin, California), and Surpass Streamline (Stryker Neurovascular, Fremont, California), is not directly established and largely inferred. Purpose This study aimed to compare the efficacy of different FDs in treating sidewall ICA intracranial aneurysms. Methods We conducted a retrospective review of prospectively maintained databases from eighteen academic institutions from 2009-2016, comprising 444 patients treated with one of four devices for sidewall ICA aneurysms. Data on demographics, aneurysm characteristics, treatment outcomes, and complications were analyzed. Angiographic and clinical outcomes were assessed using various imaging modalities and modified Rankin Scale (mRS). Propensity score weighting was employed to balance confounding variables. The data analysis used Kaplan-Meier curves, logistic regression, and Cox proportional-hazards regression. Results While there were no significant differences in retreatment rates, functional outcomes (mRS 0-1), and thromboembolic complications between the four devices, the probability of achieving adequate occlusion at the last follow-up was highest in Surpass device (HR: 4.59; CI: 2.75-7.66, p < 0.001), followed by FRED (HR: 2.23; CI: 1.44-3.46, p < 0.001), PED (HR: 1.72; CI: 1.10-2.70, p = 0.018), and Silk (HR: 1.0 ref. standard). The only hemorrhagic complications were with Surpass (1%). Conclusion All the first-generation devices achieved good clinical outcomes and retreatment rates in treating ICA sidewall aneurysms. Prospective studies are needed to explore the nuanced differences between these devices in the long term.

引用

页码：907 / 917

页数：11

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