Frequency and predictors of endoleaks and long-term patency after covered stent placement for the treatment of intracranial aneurysms: a prospective, non-randomised multicentre experience

被引:40
作者
Zhu, Yue-Qi [1 ]
Li, Ming-Hua [1 ]
Lin, Feng [2 ]
Song, Dong-Lei [3 ]
Tan, Hua-Qiao [1 ]
Gu, Bin-Xian [1 ]
Zhang, Hong-Qi [2 ]
Leng, Bin [2 ]
Zhang, Pei-Lei [1 ]
机构
[1] Shanghai Jiao Tong Univ, Sch Med, Affiliated Peoples Hosp 6, Dept Diagnost & Intervent Radiol, Shanghai 200233, Peoples R China
[2] Capital Med Univ, Affiliated Xuanwu Hosp, Dept Neurosurg, Beijing 100053, Peoples R China
[3] Fudan Univ, Affiliated Huashan Hosp, Dept Neurosurg, Shanghai 200040, Peoples R China
基金
中国国家自然科学基金;
关键词
Intracranial aneurysm; Covered stent; Endoleak; In-stent stenosis; Multiple regression analysis; PIPELINE EMBOLIZATION DEVICE; INTERNAL CAROTID-ARTERY; FOLLOW-UP; RECONSTRUCTION; SMOKING;
D O I
10.1007/s00330-012-2581-4
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
We investigated immediate/late endoleaks and long-term patency following stent-graft placement for treatment of intracranial aneurysms located within the distal internal carotid artery (ICA) or vertebral artery (VA). Forty-five aneurysms in 41 patients receiving covered stents in three centres were followed. Outcome measures included aneurysm occlusion rate, endoleaks, late in-stent stenosis rate, clinical improvement, neurological deficiencies and death. Total aneurysm exclusion was achieved in 69.2% (n = 27), with 30.8% (n = 12) experiencing immediate residual endoleaks. Angiographic follow-up (mean 43.5 +/- 14.3 months) revealed that 87.2% (n = 34) were completely occluded with only 12.8% (n = 5) showing residual endoleaks. Predictors of immediate endoleaks in our patient group were stent number (P = 0.023) and stent diameter (P = 0.022), while predictors of late endoleaks in our patient group were stent diameter (P = 0.035) and stent angulation (P = 0.021). Late in-stent stenosis rates were 18.0 +/- 13.3 and 29.0 +/- 18.5% compared with the period immediately following implantation at 2- and 6-year follow-ups respectively. Smoking (P = 0.017) and stent angulation (P = 0.020) were predictors of late in-stent stenosis. Treating intracranial aneurysms with Willis stent-grafts has an acceptable immediate and late occlusion rate and long-term stented artery patency rate.
引用
收藏
页码:287 / 297
页数:11
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