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.
引用
收藏
页码:1145 / 1152
页数:8
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