[1]李元智,张航,马亚静,等.中短期随访时未发生支架内狭窄的Pipeline血流导向装置的长期随访结果[J].介入放射学杂志,2024,33(10):1057-1063.
 LI Yuanzhi,ZHANG Hang,MA Yajing,et al.Long term follow-up results of pipeline embolization devices showing no in-stent stenosis at short-to-medium term follow-up examination[J].journal interventional radiology,2024,33(10):1057-1063.
点击复制

中短期随访时未发生支架内狭窄的Pipeline血流导向装置的长期随访结果()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年10
页码:
1057-1063
栏目:
神经介入
出版日期:
2024-10-21

文章信息/Info

Title:
Long term follow-up results of pipeline embolization devices showing no in-stent stenosis at short-to-medium term follow-up examination
作者:
李元智张航马亚静司明磊付宇郭新宾王林玉管生
Author(s):
LI YuanzhiZHANG HangMA YajingSI MingleiFU YuGUO XinbinWANG LinyuGUAN Sheng.
Department of Neurointervention,First Affiliated Hospital,Zhengzhou University,Zhengzhou,Henan Province 450052,China
关键词:
【关键词】颅内动脉瘤Pipeline血流导向装置支架内狭窄长期随访
文献标志码:
A
摘要:
【摘要】目的探究Pipeline血流导向装置(pipeline embolization device,PED)治疗颅内动脉瘤术后中短期随访时无支架内狭窄(in-stent stenosis,ISS)的患者在长期随访时ISS的发生率。方法回顾性收集2015年4月至2022年6月在郑州大学第一附属医院神经介入科接受PED治疗的患者资料,筛选出首次DSA随访时未发生ISS并完成术后12个月以上长期随访的颅内动脉瘤患者。收集其相关的临床及影像资料,统计在术后12个月以上的长期随访时ISS的发生率。ISS定义为随访时支架所在范围载瘤动脉较术后即刻管腔丢失>25%。结果本研究57例患者共61枚动脉瘤,置入68枚PED,41枚(67.21%) 动脉瘤采用单独PED植入,20枚(32.79%)动脉瘤采用PED联合弹簧圈栓塞。中位初次随访时间184.0(119.0,212.5) d,术后12个月以上的长期随访时,35枚(57.38%)动脉瘤采用DSA随访,22枚(36.07%)动脉瘤采用CTA随访,4枚(6.56%)动脉瘤采用磁共振3D-SPACE序列随访。中位术后长期随访时间538.0(407.5,678.0) d,ISS发生率为0。所有患者均未出现ISS相关神经系统症状。结论PED治疗颅内动脉瘤术后ISS发生率低,短期随访时未发现ISS者,长期随访倾向于无ISS事件发生。

参考文献/References:

[1]中国医师协会神经介入专业委员会出血性脑血管病神经介入专业委员会,中国医师协会神经外科医师分会神经介入专业委员会,中国医师协会介入医师分会神经介入专业委员会.血流导向装置治疗颅内动脉瘤的中国专家共识[J].中华神经外科杂志,2020,36:433-445.
[2]Ravindran K,Salem MM,Alturki AY,et al.Endothelialization following flow diversion for intracranial aneurysms:a systematic review[J].AJNR Am J Neuroradiol,2019,40:295-301.
[3]Kadirvel R,Ding YH,Dai D,et al.Cellular mechanisms of aneurysm occlusion after treatment with a flow diverter[J].Radiology,2014,270:394-399.
[4]Ravindran K,Casabella AM,Cebral J,et al.Mechanism of action and biology of flow diverters in the treatment of intracranial aneurysms[J].Neurosurgery,2020,86:S13-S19.
[5]Essbaiheen F,AlQahtani H,Almansoori TM,et al.Transient in-stent stenosis at mid-term angiographic follow-up in patients treated with SILK flow diverter stents:incidence,clinical significance and long-term follow-up[J].J Neurointerv Surg,2019,11:166-170.
[6]You W,Lv J,Li Z,et al.The incidence and predictors of in-stent stenosis after pipeline flow-diverter stenting for intracranial aneurysm treatment[J].Front Neurol,2023,14:1140497.
[7]Ravindran K,Salem MM,Enriquez-Marulanda A,et al.Quantitative assessment of in-stent stenosis after pipeline embolization device treatment of intracranial aneurysms:a single-institution series and systematic review[J].World Neurosurg,2018,120:e1031-e1040.
[8]司明磊,魏森,管生,等.Pipeline血流导向装置治疗颅内动脉瘤术后支架内狭窄的影响因素分析[J].中华放射学杂志,2023,57:67-72.
[9]Mühl-Benninghaus R,Haumann A,Simgen A,et al.Transient in-stent stenosis:a common finding after flow diverter implantation[J].J Neurointerv Surg,2019,11:196-199.
[10]Gui S,Chen X,Wei D,et al.Long-term outcomes and dynamic changes of in-stent stenosis after Pipeline embolization device treatment of intracranial aneurysms[J].J Neurointerv Surg,2023,15:1187-1193.
[11]张莹,罗斌,康慧斌,等.Pipeline栓塞装置治疗大脑中动脉动脉瘤的疗效:一项回顾性多中心研究[J].中国临床神经外科杂志,2023,28:225-229.
[12]Hanel RA,Cortez GM,Lopes DK,et al.Prospective study on embolization of intracranial aneurysms with the pipeline device (PREMIER study):3-year results with the application of a flow diverter specific occlusion classification[J].J Neurointerv Surg,2023,15:248-254.
[13]Lin N,Brouillard AM,Keigher KM,et al.Utilization of pipeline embolization device for treatment of ruptured intracranial aneurysms:US multicenter experience[J].J Neurointerv Surg,2015,7:808-815.
[14]Luo B,Kang H,Zhang H,et al.Pipeline embolization device for intracranial aneurysms in a large Chinese cohort:factors related to aneurysm occlusion[J].Ther Adv Neurol Disord,2020,13:1756286420967828.
[15]Deng Q,Feng W,Hai H,et al.Evaluation of the safety and efficacy of a Pipeline Flex embolization device for treatment of large,wide-necked intracranial aneurysms[J].J Interv Med,2018,1:229-233.
[16]Kallmes DF,Brinjikji W,Boccardi E,et al.Aneurysm study of pipeline in an observational registry(ASPIRe)[J].Interv Neurol,2016,5:89-99.
[17]Kang H,Zhou Y,Luo B,et al.Pipeline embolization device for intracranial aneurysms in a large Chinese cohort:complication risk factor analysis[J].Neurotherapeutics,2021,18:1198-1206.
[18]John S,Bain MD,Hui FK,et al.Long-term follow-up of in-stent stenosis after pipeline flow diversion treatment of intracranial aneurysms[J].Neurosurgery,2016,78:862-867.
[19]Cohen JE,Gomori JM,Moscovici S,et al.Delayed complications after flow-diverter stenting:reactive in-stent stenosis and creeping stents[J].J Clin Neurosci,2014,21:1116-1122.
[20]Chalouhi N,Polifka A,Daou B,et al.In-Pipeline stenosis:incidence,predictors,and clinical outcomes[J].Neurosurgery,2015,77:875-879.
[21]Lylyk P,Miranda C,Ceratto R,et al.Curative endovascular reconstruction of cerebral aneurysms with the pipeline embolization device:the Buenos Aires experience[J].Neurosurgery,2009,64:632-642.
[22]Becske T,Kallmes DF,Saatci I,et al.Pipeline for uncoilable or failed aneurysms:results from a multicenter clinical trial[J].Radiology,2013,267:858-868.
[23]Ma Y,Ji Z,Yang W,et al.Role of optical coherence tomography in pipeline embolization device for the treatment of vertebral-basilar artery dissecting aneurysms[J].J Neurointerv Surg,2024,16:308-312.
[24]Marosfoi M,Clarencon F,Langan ET,et al.Acute thrombus formation on phosphorilcholine surface modified flow diverters[J].J Neurointerv Surg,2018,10:406-411.
[25]Monteiro A,Lopes DK,Aghaebrahim A,et al.Optical coherence tomography for elucidation of flow-diversion phenomena:the concept of endothelized mural thrombus behind reversible in-stent stenosis in flow-diverters[J].Interv Neuroradiol,2021,27:774-780.
[26]Matsuda Y,Chung J,Lopes DK.Analysis of neointima development in flow diverters using optical coherence tomography imaging[J].J Neurointerv Surg,2018,10:162-167.
[27]de Prado AP,Perez-Martínez C,Cuellas-Ramon C,et al.Time course of reendothelialization of stents in a normal coronary swine model:characterization and quantification[J].Vet Pathol,2011,48:1109-1117.
[28]Virmani R,Kolodgie FD,Farb A,et al.Drug eluting stents:are human and animal studies comparable?[J].Heart,2003,89:133-138.
[29]Joner M,Nakazawa G,Finn AV,et al.Endothelial cell recovery between comparator polymer-based drug-eluting stents[J].J Am Coll Cardiol,2008,52:333-342.
[30]Liu W,Dai D,Ding YH,et al.Cellular responses to flow diverters in a tissue-engineered aneurysm model[J].J Neurointerv Surg,2021,13:746-751.
[31]Aguilar Perez M,Bhogal P,Henkes E,et al.In-stent stenosis after p64 flow diverter treatment[J].Clin Neuroradiol,2018,28:563-568.
[32]Mitra AK,Agrawal DK.In stent restenosis:bane of the stent era[J].J Clin Pathol,2006,59:232-239.
[33]Welt FG,Tso C,Edelman ER,et al.Leukocyte recruitment and expression of chemokines following different forms of vascular injury[J].Vasc Med,2003,8:1-7.
[34]Chua MMJ,Silveira L,Moore J,et al.Flow diversion for treatment of intracranial aneurysms:mechanism and implications[J].Ann Neurol,2019,85:793-800.
[35]Sweid A,Starke RM,Herial N,et al.Predictors of complications,functional outcome,and morbidity in a large cohort treated with flow diversion[J].Neurosurgery,2020,87:730-743.
[36]Wang T,Richard SA,Jiao H,et al.Institutional experience of in-stent stenosis after pipeline flow diverter implantation:a retrospective analysis of 6 isolated cases out of 118 patients[J].Medicine(Baltimore),2021,100:e25149.
[37]Gao H,You W,Wei D,et al.Tortuosity of parent artery predicts in-stent stenosis after pipeline flow-diverter stenting for internal carotid artery aneurysms[J].Front Neurol,2022,13:1034402.
[38]Shibuya M,Fujii K,Fukunaga M,et al.Natural history of low-intensity neointimal tissue after an everolimus-eluting stent implantation:a serial observation with optical coherence tomography[J].Heart Vessels,2015,30:136-139.
[39]李航,白卫星,贺迎坤,等.PipelineTM栓塞装置治疗颅内动脉瘤术后并发症研究进展[J].介入放射学杂志,2017,26:760-764.

相似文献/References:

[1]沈 寻,王文蕾,秦怀海,等.Neuroform EZ支架辅助颅内动脉瘤栓塞后动脉内膜增生的动态演化规律[J].介入放射学杂志,2023,32(01):48.
 SHEN Xun,WANG Wenlei,QIN Huaihai,et al.The dynamic evolution of the arterial intimal hyperplasia after Neuroform EZ stent-assisted treatment of intracranial aneurysms[J].journal interventional radiology,2023,32(10):48.

备注/Memo

备注/Memo:
(收稿日期:2023-10-09)
(本文编辑:茹实)
更新日期/Last Update: 2024-10-17