التفاصيل البيبلوغرافية
| العنوان: |
Endoluminal flow diverting stents for middle cerebral artery bifurcation aneurysms: multicenter cohort. |
| المؤلفون: |
Salem, Mohamed M., Khorasanizadeh, Mirhojjat, Lay, Sovann V., Renieri, Leonardo, Kuhn, Anna L., Sweid, Ahmad, Massari, Francesco, Moore, Justin M., Tjoumakaris, Stavropoula I., Jabbour, Pascal, Puri, Ajit S., Ogilvy, Christopher S., Jankowitz, Brian T., Burkhardt, Jan-Karl, Kan, Peter, Limbucci, Nicola, Cognard, Christophe, Thomas, Ajith J. |
| المصدر: |
Journal of NeuroInterventional Surgery; Nov2022, Vol. 14 Issue 11, p1-7, 7p |
| مصطلحات موضوعية: |
DISEASE relapse, SURGICAL complication risk factors, THROMBOEMBOLISM risk factors, CEREBRAL artery surgery, INTRACRANIAL aneurysm surgery, RESEARCH, CEREBRAL hemorrhage, CONFIDENCE intervals, NEUROSURGERY, MULTIVARIATE analysis, MULTIPLE regression analysis, SURGICAL stents, RETROSPECTIVE studies, ACQUISITION of data, FISHER exact test, TREATMENT effectiveness, SEVERITY of illness index, SEX distribution, MEDICAL records, DESCRIPTIVE statistics, CHI-squared test, DATA analysis software, STATISTICAL models, ODDS ratio, ANGIOPLASTY, INTRACRANIAL aneurysms, CEREBRAL ischemia, DISEASE risk factors |
| مستخلص: |
Background Data 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. Methods Prospectively-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. Results 87 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 posttreatment, 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). Conclusion FDS 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. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
