Pipeline Embolization Device for Intracranial Aneurysms in a Large Chinese Cohort: Complication Risk Factor Analysis

被引：41
作者：
Kang, Huibin [1 ,2 ]
Zhou, Yu [3 ]
Luo, Bin [1 ,2 ]
Lv, Nan [3 ]
Zhang, Hongqi [4 ]
Li, Tianxiao [5 ]
Song, Donglei [6 ]
Zhao, Yuanli [7 ]
Guan, Sheng [8 ]
Maimaitili, Aisha [9 ]
Wang, Yunyan [10 ]
Feng, Wenfeng [11 ]
Wang, Yang [12 ]
Wan, Jieqing [13 ]
Mao, Guohua [14 ]
Shi, Huaizhang [15 ]
Yang, Xinjian [1 ,2 ]
Liu, Jianmin [3 ]
机构：
[1] Capital Med Univ, Beijing Neurosurg Inst, Dept Intervent Neuroradiol, 119 South Fourth Ring West Rd, Beijing 100050, Peoples R China
[2] Capital Med Univ, Beijing Tiantan Hosp, 119 South Fourth Ring West Rd, Beijing 100050, Peoples R China
[3] Naval Med Univ, Changhai Hosp, Dept Neurosurg, 168 Changhai Rd, Shanghai 200433, Peoples R China
[4] Capital Med Univ, Xuanwu Hosp, Beijing, Peoples R China
[5] Zhengzhou Univ, Peoples Hosp, Zhengzhou, Peoples R China
[6] Shanghai Donglei Brain Hosp, Shanghai, Peoples R China
[7] Peking Univ, Int Hosp, Beijing, Peoples R China
[8] Zhengzhou Univ, Affiliated Hosp 1, Zhengzhou, Peoples R China
[9] Xinjiang Med Univ, Affiliated Hosp 1, Uruqi, Peoples R China
[10] Shandong Univ, Qilu Hosp, Jinan, Peoples R China
[11] Southern Med Univ, Nanfang Hosp, Guangzhou, Peoples R China
[12] Nanchang Univ, Affiliated Hosp 1, Nanchang, Jiangxi, Peoples R China
[13] Shanghai Jiao Tong Univ, Renji Hosp, Sch Med, Shanghai, Peoples R China
[14] Nanchang Univ, Affiliated Hosp 2, Nanchang, Jiangxi, Peoples R China
[15] Harbin Med Univ, Affiliated Hosp 1, Harbin, Peoples R China
来源：
NEUROTHERAPEUTICS | 2021年 / 18卷 / 02期
基金：
中国国家自然科学基金;
关键词：
Complications; intracranial aneurysms; China; ischemic; multi-center; endovascular treatment; Pipeline embolization device; FLOW DIVERSION;
D O I：
10.1007/s13311-020-00990-8
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
During intracranial aneurysm embolization with the Pipeline embolization device (PED), ischemic and hemorrhagic complications have been observed in cases among Western populations. The postmarket multicenter registry study on the embolization of intracranial aneurysms with the PED in China, i.e., the PLUS study, was performed to assess real-world predictors of complications and functional outcomes in patients treated with the PED in a Chinese population. All patients with intracranial aneurysms who underwent embolization using the PED between November 2014 and October 2019 across 14 centers in China were included. The study endpoints included preoperative and early postoperative (< 30 days) functional outcomes (modified Rankin scale [mRS] scores) and complications related to PED treatment at early postoperative and follow-up time points (3-36 months). Multivariate analysis was performed to identify risk factors for complications. A total of 1171 consecutive patients (mean age, 53.9 +/- 11.4; female, 69.6% [813/1171]) with 1322 aneurysms were included in the study. Hypertension, basilar artery aneurysms, and successful deployment after adjustment or unsuccessful device deployment were found to be independent predictors of ischemic stroke, while the use of the Flex PED and incomplete occlusion immediately after treatment were protective factors. An aneurysm size > 10 mm, distal anterior circulation aneurysms, and adjunctive coiling were found to be independent predictors of delayed aneurysm rupture, distal intraparenchymal hemorrhage, and neurological compression symptoms, respectively. The rate of PED-related complications in the PLUS study was similar to that in Western populations. The PLUS study identified successful deployment after adjustment or unsuccessful device deployment and the degree of immediate postoperative occlusion as novel independent predictors of PED-related ischemic stroke in a Chinese population. Identifier: NCT03831672
引用
收藏
页码：1198 / 1206
页数：9
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