Cargando…
Flow diversion for posterior circulation aneurysms: a multicenter retrospective study
BACKGROUND: The prevalence of intracranial aneurysms is approximately 3% worldwide. Posterior circulation (PC) aneurysms have a higher risk of treatment complications than anterior circulation aneurysms. Improving the survival rate and quality of life of patients with PC aneurysms remains one of the...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10262625/ https://www.ncbi.nlm.nih.gov/pubmed/37324979 http://dx.doi.org/10.1177/17562864231176187 |
_version_ | 1785058089901228032 |
---|---|
author | Qi, Peng Tong, Xin Liang, Xin Xue, Xiaopeng Wu, Zhongxue Feng, Xin Zhang, Meng Jiang, Zhiqun Wang, Daming Liu, Aihua |
author_facet | Qi, Peng Tong, Xin Liang, Xin Xue, Xiaopeng Wu, Zhongxue Feng, Xin Zhang, Meng Jiang, Zhiqun Wang, Daming Liu, Aihua |
author_sort | Qi, Peng |
collection | PubMed |
description | BACKGROUND: The prevalence of intracranial aneurysms is approximately 3% worldwide. Posterior circulation (PC) aneurysms have a higher risk of treatment complications than anterior circulation aneurysms. Improving the survival rate and quality of life of patients with PC aneurysms remains one of the most important issues in the field. OBJECTIVES: Flow diverter (FD) treatment of PC aneurysms remains controversial. We aimed to investigate the effects of FD treatment and analyze differences among different application methods or aneurysm types in PC aneurysms. DESIGN: This is a multicenter retrospective study. METHODS: Patients with PC aneurysms treated with the pipeline embolization device (PED) or Tubridge embolization device (TED) between 2015 and 2020 in five neurovascular centers were retrospectively enrolled. The primary outcomes were major perioperative complication, clinical outcome, and aneurysm occlusion rates. Univariable and multivariable logistic regression analyses were used to determine the risk factors of each outcome. RESULTS: In total, 252 aneurysms were included. Major perioperative complication, favorable clinical outcome, and complete occlusion rates were 7.5%, 91.0%, and 79.1%, respectively. Compared with other types of aneurysms, dissecting aneurysms had the best clinical outcome and highest occlusion rate. Both clinical and angiographic outcomes were independently associated with the aneurysm location at the basilar artery. Aneurysm size was not associated with any outcome. TED had similar clinical and angiographic outcomes compared with PED but more perioperative major complications. Tandem treatment and coiling assistance may have poorer clinical outcomes but similar occlusion rates. Single- and multiple-stent treatments had similar outcomes. CONCLUSION: FD treatment of PC aneurysms achieved favorable clinical outcomes and long-term aneurysm occlusion rates with acceptable perioperative complication rates, especially in dissecting and non-basilar artery aneurysms. There was no additional improvement in outcomes with coiling assistance, multi-stent application, or tandem treatment. Therefore, the use of PC aneurysms should be carefully considered. |
format | Online Article Text |
id | pubmed-10262625 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-102626252023-06-15 Flow diversion for posterior circulation aneurysms: a multicenter retrospective study Qi, Peng Tong, Xin Liang, Xin Xue, Xiaopeng Wu, Zhongxue Feng, Xin Zhang, Meng Jiang, Zhiqun Wang, Daming Liu, Aihua Ther Adv Neurol Disord Original Research BACKGROUND: The prevalence of intracranial aneurysms is approximately 3% worldwide. Posterior circulation (PC) aneurysms have a higher risk of treatment complications than anterior circulation aneurysms. Improving the survival rate and quality of life of patients with PC aneurysms remains one of the most important issues in the field. OBJECTIVES: Flow diverter (FD) treatment of PC aneurysms remains controversial. We aimed to investigate the effects of FD treatment and analyze differences among different application methods or aneurysm types in PC aneurysms. DESIGN: This is a multicenter retrospective study. METHODS: Patients with PC aneurysms treated with the pipeline embolization device (PED) or Tubridge embolization device (TED) between 2015 and 2020 in five neurovascular centers were retrospectively enrolled. The primary outcomes were major perioperative complication, clinical outcome, and aneurysm occlusion rates. Univariable and multivariable logistic regression analyses were used to determine the risk factors of each outcome. RESULTS: In total, 252 aneurysms were included. Major perioperative complication, favorable clinical outcome, and complete occlusion rates were 7.5%, 91.0%, and 79.1%, respectively. Compared with other types of aneurysms, dissecting aneurysms had the best clinical outcome and highest occlusion rate. Both clinical and angiographic outcomes were independently associated with the aneurysm location at the basilar artery. Aneurysm size was not associated with any outcome. TED had similar clinical and angiographic outcomes compared with PED but more perioperative major complications. Tandem treatment and coiling assistance may have poorer clinical outcomes but similar occlusion rates. Single- and multiple-stent treatments had similar outcomes. CONCLUSION: FD treatment of PC aneurysms achieved favorable clinical outcomes and long-term aneurysm occlusion rates with acceptable perioperative complication rates, especially in dissecting and non-basilar artery aneurysms. There was no additional improvement in outcomes with coiling assistance, multi-stent application, or tandem treatment. Therefore, the use of PC aneurysms should be carefully considered. SAGE Publications 2023-06-08 /pmc/articles/PMC10262625/ /pubmed/37324979 http://dx.doi.org/10.1177/17562864231176187 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Qi, Peng Tong, Xin Liang, Xin Xue, Xiaopeng Wu, Zhongxue Feng, Xin Zhang, Meng Jiang, Zhiqun Wang, Daming Liu, Aihua Flow diversion for posterior circulation aneurysms: a multicenter retrospective study |
title | Flow diversion for posterior circulation aneurysms: a multicenter retrospective study |
title_full | Flow diversion for posterior circulation aneurysms: a multicenter retrospective study |
title_fullStr | Flow diversion for posterior circulation aneurysms: a multicenter retrospective study |
title_full_unstemmed | Flow diversion for posterior circulation aneurysms: a multicenter retrospective study |
title_short | Flow diversion for posterior circulation aneurysms: a multicenter retrospective study |
title_sort | flow diversion for posterior circulation aneurysms: a multicenter retrospective study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10262625/ https://www.ncbi.nlm.nih.gov/pubmed/37324979 http://dx.doi.org/10.1177/17562864231176187 |
work_keys_str_mv | AT qipeng flowdiversionforposteriorcirculationaneurysmsamulticenterretrospectivestudy AT tongxin flowdiversionforposteriorcirculationaneurysmsamulticenterretrospectivestudy AT liangxin flowdiversionforposteriorcirculationaneurysmsamulticenterretrospectivestudy AT xuexiaopeng flowdiversionforposteriorcirculationaneurysmsamulticenterretrospectivestudy AT wuzhongxue flowdiversionforposteriorcirculationaneurysmsamulticenterretrospectivestudy AT fengxin flowdiversionforposteriorcirculationaneurysmsamulticenterretrospectivestudy AT zhangmeng flowdiversionforposteriorcirculationaneurysmsamulticenterretrospectivestudy AT jiangzhiqun flowdiversionforposteriorcirculationaneurysmsamulticenterretrospectivestudy AT wangdaming flowdiversionforposteriorcirculationaneurysmsamulticenterretrospectivestudy AT liuaihua flowdiversionforposteriorcirculationaneurysmsamulticenterretrospectivestudy |