Italian multicenter experience with flow-diverter devices for intracranial unruptured aneurysm treatment with periprocedural complications-a retrospective data analysis

被引:149
作者
Briganti, Francesco [1 ]
Napoli, Manuela [1 ]
Tortora, Fabio [2 ]
Solari, Domenico [3 ]
Bergui, Mauro [4 ]
Boccardi, Edoardo [5 ]
Cagliari, Enrico [6 ]
Castellan, Lucio [7 ]
Causin, Francesco [8 ]
Ciceri, Elisa [9 ]
Cirillo, Luigi [10 ]
De Blasi, Roberto [11 ]
Delehaye, Luigi [12 ]
Di Paola, Francesco [13 ]
Fontana, Andrea [14 ]
Gasparotti, Roberto [15 ]
Guidetti, Giulio [16 ]
Divenuto, Ignazio [17 ]
Iannucci, Giuseppe [18 ]
Isalberti, Maurizio [19 ]
Leonardi, Marco [10 ]
Lupo, Fernando [20 ]
Mangiafico, Salvatore [21 ]
Manto, Andrea [22 ]
Menozzi, Roberto [23 ]
Muto, Mario [24 ]
Nuzzi, Nunzio Paolo [25 ]
Papa, Rosario [19 ]
Petralia, Benedetto [26 ]
Piano, Mariangela [5 ]
Resta, Maurizio [27 ]
Padolecchia, Riccardo [28 ]
Saletti, Andrea [29 ]
Sirabella, Giovanni [30 ]
Bolge, Luca Piero Valvassori [5 ]
机构
[1] Univ Naples Federico II, Intervent Neuroradiol Unit, I-80131 Naples, Italy
[2] Univ Naples 2, Inst Radiol, Naples, Italy
[3] Univ Naples Federico II, Div Neurosurg, I-80131 Naples, Italy
[4] Univ Turin, Neuroradiol Div, Turin, Italy
[5] Osped Niguarda Ca Granda, Intervent Neuroradiol Div, Milan, Italy
[6] Osped Angelo, Neuroradiol Unit, Venice, Italy
[7] San Martino Hosp, Dept Neuroradiol, Genoa, Italy
[8] City Hosp, Neuroradiol Div, Vicenza, Italy
[9] Fdn IRCCS Ist Neurol Carlo Besta, Neuroradiol Unit, Milan, Italy
[10] Bellaria Maggiore Hosp, Dept Neuroradiol, Bologna, Italy
[11] Univ Hosp, Unit Neuroradiol & Intervent Radiol, Bari, Italy
[12] San Giovanni Bosco Hosp, Unit Neuroradiol, Naples, Italy
[13] Treviso Hosp, Dept Neuroradiol, Treviso, Italy
[14] IRCCS Casa Sollievo Sofferenza, Unit Biostat, San Giovanni Rotondo, Italy
[15] Univ Brescia, Osped Civili, Inst Neuroradiol, Brescia, Italy
[16] Univ Roma La Sapienza, Sch Med, Rome, Italy
[17] Amedeo Avogadro Univ, Dept Radiol, Novara, Italy
[18] Vicenza Hosp, Dept Neuroradiol, Vicenza, Italy
[19] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Milan, Italy
[20] V Fazzi Hosp, Dept Neuroradiol, Lecce, Italy
[21] Careggi Hosp, Dept Neuroradiol, Florence, Italy
[22] Umberto I Hosp, Dept Neuroradiol, Salerno, Italy
[23] Univ Parma, Dept Neuroradiol, I-43100 Parma, Italy
[24] A Cardarelli Hosp, Neuroradiol Unit, Naples, Italy
[25] EO Osped Galliera, Unit Diagnost & Intervent Neuroradiol, Genoa, Italy
[26] Udine Univ Hosp, Dept Neuroradiol, Udine, Italy
[27] SS Annunziata Hosp, Dept Radiol & Neuroradiol, Taranto, Italy
[28] Santa Corona Hosp, Neuroradiol Unit, Sanova, Italy
[29] St Anna Hosp, Neuroradiol Unit, Ferrara, Italy
[30] Loreto Nuovo Hosp, Neuroradiol Unit, Naples, Italy
关键词
Flow diverter device; Pipeline embolization device; Silk embolization device; Intracranial aneurysms; Endovascular treatment; PIPELINE EMBOLIZATION DEVICE; CEREBRAL ANEURYSMS; NEUROFORM STENT; ENDOVASCULAR TREATMENT; RECONSTRUCTION; COILING; GIANT;
D O I
10.1007/s00234-012-1047-3
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We report the experiences of 25 Italian centers, analyzing intra- and periprocedural complications of endovascular treatment of intracranial aneurysms using Silk (Balt Extrusion, Montmorency, France) and pipeline embolization devices (EV3 Inc, Irvine California). Two hundred seventy-three patients with 295 cerebral aneurysms, enrolled in 25 centers in Italy and treated with the new flow-diverter devices, were evaluated; 142 patients were treated with Silk and 130 with pipeline (in one case, both devices were used). In 14 (5.2 %) cases devices were used with coils. Aneurysm size was > 15 mm in 46.9 %, 5-15 mm in 42.2 %, and < 5 mm in 10.8 %. Aneurysm locations were supraclinoid internal carotid artery (ICA) in 163 cases (55.2 %), cavernous ICA in 76 (25.7 %), middle cerebral artery in 11 (3.7 %), PCoA in 6 (2 %), and ACoA in 2 (0.7 %); the vertebrobasilar system accounted for 32 cases (10.8 %) and PCA in 5 (1.7 %). Technical adverse events occurred with 59 patients (21.6 %); 5 patients died after ischemic events, 10 to hemorrhagic complications, and 1 from external ventricular drain positioning. At 1 month, morbidity and mortality rates were 3.7 % and 5.9 %, respectively Our retrospective study confirms that morbidity and mortality rates in treatment with FDD of unruptured wide-neck or untreatable cerebral aneurysms do not differ from those reported in the largest series.
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收藏
页码:1145 / 1152
页数:8
相关论文
共 31 条
[1]  
Augsburger L, 2009, CLIN NEURORADIOL, V19, P204, DOI 10.1007/s00062-009-9005-0
[2]   Early Experience in the Treatment of Intra-Cranial Aneurysms by Endovascular Flow Diversion: A Multicentre Prospective Study [J].
Byrne, James V. ;
Beltechi, Radu ;
Yarnold, Julia A. ;
Birks, Jacqueline ;
Kamran, Mudassar .
PLOS ONE, 2010, 5 (09) :1-8
[3]   Retreatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the international subarachnoid aneurysm trial (ISAT) [J].
Campi, Adriana ;
Ramzi, Najib ;
Molyneux, Andrew J. ;
Summers, Paul E. ;
Kerr, Richard S. C. ;
Sneade, Mary ;
Yarnold, Julia A. ;
Rischmiller, Joan ;
Byrne, James V. .
STROKE, 2007, 38 (05) :1538-1544
[4]   Balloon-in-stent technique for the constructive endovascular treatment of "ultra-wide necked" circumferential aneurysms [J].
Fiorella, D ;
Albuquerque, FC ;
Masaryk, TJ ;
Rasmussen, PA ;
McDougall, CG .
NEUROSURGERY, 2005, 57 (06) :1218-1226
[5]   Usefulness of the neuroform stent for the treatment of cerebral aneurysms: Results at initial (3-6-mo) follow-up [J].
Fiorella, D ;
Albuquerque, FC ;
Deshmukh, VR ;
McDougall, CG .
NEUROSURGERY, 2005, 56 (06) :1191-1201
[6]   Neuroform stent assisted aneurysm treatment: evolving treatment strategies, complications and results of long term follow-up [J].
Fiorella, D. ;
Albuquerque, F. C. ;
Woo, H. ;
Rasmussen, P. A. ;
Masaryk, T. J. ;
McDougall, C. G. .
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2010, 2 (01) :16-22
[7]   Reconstruction of the right anterior circulation with the Pipeline embolization device to achieve treatment of a progressively symptomatic, large carotid aneurysm [J].
Fiorella, D. ;
Albuquerque, F. ;
Gonzalez, F. ;
McDougall, C. G. ;
Nelson, P. K. .
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2010, 2 (01) :31-37
[8]   Curative cerebrovascular reconstruction with the Pipeline embolization device: the emergence of definitive endovascular therapy for intracranial aneurysms [J].
Fiorella, D. ;
Lylyk, P. ;
Szikora, I. ;
Kelly, M. E. ;
Albuquerque, F. C. ;
McDougall, C. G. ;
Nelson, P. K. .
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2009, 1 (01) :56-65
[9]   Definitive reconstruction of circumferential fusiform intracranial aneurysms with the pipeline embolization device [J].
Fiorella, David ;
Woo, Henry H. ;
Albuquerque, Felipe C. ;
Nelson, Peter K. .
NEUROSURGERY, 2008, 62 (05) :1115-1120
[10]   CURATIVE RECONSTRUCTION OF A GIANT MIDBASILAR TRUNK ANEURYSM WITH THE PIPELINE EMBOLIZATION DEVICE [J].
Fiorella, David ;
Kelly, Michael E. ;
Albuquerque, Felipe C. ;
Nelson, Peter K. .
NEUROSURGERY, 2009, 64 (02) :212-217