Endoluminal flow diverting stents for middle cerebral artery bifurcation aneurysms: multicenter cohort
| العنوان: | Endoluminal flow diverting stents for middle cerebral artery bifurcation aneurysms: multicenter cohort |
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| المؤلفون: | Christophe Cognard, Leonardo Renieri, Anna Luisa Kühn, Jan-Karl Burkhardt, Stavropoula Tjoumakaris, Nicola Limbucci, Justin M. Moore, Mohamed M. Salem, MirHojjat Khorasanizadeh, Christopher S. Ogilvy, Ajit S. Puri, Peter Kan, Sovann V Lay, Pascal Jabbour, Francesco Massari, Ajith J. Thomas, Brian T Jankowitz, Ahmad Sweid |
| المصدر: | Journal of NeuroInterventional Surgery. 14:1084-1089 |
| بيانات النشر: | BMJ, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, Middle Cerebral Artery, medicine.medical_specialty, Radiography, Single Center, Aneurysm, Modified Rankin Scale, medicine.artery, Occlusion, medicine, Humans, cardiovascular diseases, Stroke, Retrospective Studies, business.industry, Endovascular Procedures, Intracranial Aneurysm, General Medicine, Middle Aged, medicine.disease, Cerebral Angiography, Surgery, Treatment Outcome, Middle cerebral artery, Cohort, Female, Stents, Neurology (clinical), business |
| الوصف: | BackgroundData regarding the safety and efficacy of flow diverting stents (FDS) in the treatment of middle cerebral artery (MCA) bifurcation aneurysms are scarce and limited to small single center series, with particular concern for increased risk of ischemic complications with jailing one of the M2 branches.MethodsProspectively-maintained databases at six North American and European centers were queried for patients harboring MCA bifurcation aneurysms undergoing treatment with FDS (2011–2018). The pertinent clinical and radiographic data were collected and analyzed.Results87 patients (median age 60 years, 69% females) harboring 87 aneurysms were included. The majority of aneurysms were unruptured (79%); 75.9% were saccular with a median maximal diameter of 8.5 mm. Radiographic imaging follow-up was available in 88.5% of cases at a median of 16.3 months post-treatment, showing complete occlusion in 59% and near complete occlusion (90–99%) in 18% of aneurysms. The overall rate of ischemic and hemorrhagic complications was 8% and 1.1%, respectively. Symptomatic and permanent complications were encountered in 5.7% and 2.3% of patients respectively, with retreatment pursued in 2.3% of patients. Jailed branch occlusion was detected in 11.5% of cases, with clinical sequelae in 2.3%. Last follow-up modified Rankin Scale of 0–2 was noted in 96.8% of patients. On multivariate analysis, male sex was the only independent predictor of aneurysmal persistence at last follow-up imaging (p=0.019).ConclusionFDS treatment for MCA bifurcation aneurysms is feasible, with comparable safety and efficacy profiles to other available endovascular options when utilized in carefully selected aneurysms. Jailing of M2 branches was not associated with a higher risk of post-procedural ischemic complications. |
| تدمد: | 1759-8486 1759-8478 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::85454fdeb6e2a0454953dafb7aee8153Test https://doi.org/10.1136/neurintsurg-2021-018224Test |
| رقم الانضمام: | edsair.doi.dedup.....85454fdeb6e2a0454953dafb7aee8153 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17598486 17598478 |
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