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首页> 外文期刊>Neurosurgical focus >Flow diversion of tandem cerebral aneurysms: a multi-institutional retrospective study
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Flow diversion of tandem cerebral aneurysms: a multi-institutional retrospective study

机译：串联脑动脉瘤的血流转移：多机构回顾性研究

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OBJECTIVE Flow diversion has proven to be an efficacious means of treating cerebral aneurysms that are refractory to other therapeutic means. Patients with tandem aneurysms treated with flow diversion have been included in larger, previously reported series; however, there are no dedicated reports on using this technique during a single session to treat this unique subset of patients. Therefore, the authors analyzed the outcomes of patients who had undergone single-session flow diversion for the treatment of tandem aneurysms. METHODS The authors conducted a retrospective review of flow diversion with the Pipeline embolization device (PED) for the treatment of tandem aneurysms in a single session at 2 participating medical centers: University of Utah, Salt Lake City, Utah, and Barrow Neurological Institute, Phoenix, Arizona. Patient demographic data, aneurysm characteristics, treatment strategy and results, complications, and follow-up data were collected from the medical record and analyzed. RESULTS Between January 2011 and December 2015, 17 patients (12 female, 5 male) with a total of 38 aneurysms (mean size 4.7 ± 2.7 mm, mean ± SD) were treated. Sixteen patients had aneurysms in the anterior circulation, and 1 patient had tandem aneurysms in the posterior circulation. Twelve patients underwent only placement of a PED, whereas 5 underwent adjunctive coil embolization of at least 1 aneurysm. One PED was used in each of 9 patients, and 2 PEDs were required in each of 8 patients. There were 2 intraprocedural complications; however, in both instances, the patients were asymptomatic at the last follow-up. The follow-up imaging studies were available for 15 patients at a mean of 7 months after treatment (216 days, range 0–540 days). The mean initial Raymond score after treatment was 2.7 ± 0.7, and the mean final score was 1.3 ± 0.7. CONCLUSIONS In this series, the use of flow diversion for the treatment of tandem cerebral aneurysms had an acceptable safety profile, indicating that it should be considered as an effective therapy for this complicated subset of patients. Further prospective studies must be performed before more definitive conclusions can be made.
机译：目的血流转移已被证明是治疗其他治疗方法难以治疗的脑动脉瘤的有效方法。经分流治疗的串联动脉瘤患者已纳入先前报道的较大系列文献中。但是，没有专门的报告介绍在一次治疗中使用这种技术来治疗这一独特的患者子集。因此，作者分析了接受单次分流治疗串联动脉瘤的患者的预后。方法作者对犹他州盐湖城大学和凤凰城巴罗神经病学研究所的两个参与医疗中心进行了一次回顾性审查，研究了使用管道栓塞装置（PED）进行的分流治疗串联动脉瘤的方法。 ，亚利桑那州。从病历中收集并分析患者的人口统计数据，动脉瘤特征，治疗策略和结果，并发症以及随访数据。结果2011年1月至2015年12月，共治疗38例动脉瘤（平均大小4.7±2.7 mm，平均±SD）的17例患者（女性12例，男性5例）。 16例前循环有动脉瘤，1例后循环有串联动脉瘤。 12名患者仅接受了PED的放置，而5例接受了至少1个动脉瘤的辅助线圈栓塞术。 9例患者每人使用1个PED，8例患者每人需要2个PED。有2例术中并发症;然而，在这两种情况下，患者在最后一次随访中均无症状。在治疗后平均7个月（216天，范围0–540天）中对15例患者进行了随访影像学研究。治疗后平均初始Raymond评分为2.7±0.7，平均最终评分为1.3±0.7。结论在本系列中，使用分流术治疗串联型脑动脉瘤具有可接受的安全性，表明该方法应被视为针对这种复杂患者的有效治疗方法。在做出更明确的结论之前，必须进行进一步的前瞻性研究。

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