Cargando…

Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device

Objective: Stenting in ruptured middle cerebral artery (MCA) aneurysms was reported with a high perioperative complication rate. However, the treatment devices and physician's experience have continued to evolve. We performed this retrospective study to evaluate the safety and efficacy of LVIS...

Descripción completa

Detalles Bibliográficos
Autores principales: Xue, Gaici, Zhou, Yu, Liu, Peng, Zuo, Qiao, Yang, Pengfei, Fang, Yibin, Li, Qiang, Zhao, Rui, Xu, Yi, Hong, Bo, Huang, Qinghai, Liu, Jianmin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876053/
https://www.ncbi.nlm.nih.gov/pubmed/33584524
http://dx.doi.org/10.3389/fneur.2020.631745
_version_ 1783649897032974336
author Xue, Gaici
Zhou, Yu
Liu, Peng
Zuo, Qiao
Yang, Pengfei
Fang, Yibin
Li, Qiang
Zhao, Rui
Xu, Yi
Hong, Bo
Huang, Qinghai
Liu, Jianmin
author_facet Xue, Gaici
Zhou, Yu
Liu, Peng
Zuo, Qiao
Yang, Pengfei
Fang, Yibin
Li, Qiang
Zhao, Rui
Xu, Yi
Hong, Bo
Huang, Qinghai
Liu, Jianmin
author_sort Xue, Gaici
collection PubMed
description Objective: Stenting in ruptured middle cerebral artery (MCA) aneurysms was reported with a high perioperative complication rate. However, the treatment devices and physician's experience have continued to evolve. We performed this retrospective study to evaluate the safety and efficacy of LVIS stent-assisted coiling for ruptured MCA aneurysms. Methods: Patients with acutely ruptured MCA aneurysms treated between November 2014 and October 2019 were retrospectively reviewed. Clinical and angiographic data of those treated with LVIS stents were collected from a prospectively maintained database. Results: A total of 40 patients with 40 ruptured MCA aneurysms were enrolled, which comprised 26.3% (40/152) of all the ruptured MCA aneurysms at the same time. All stents were successfully deployed except for one (2.5%), which had a poor stent opening. Ischemic procedure-related complications were encountered in three patients (7.5%). One patient died of complications related to high-grade SAH on admission. Follow-up (mean 15.9 months) angiography was performed for 36 patients, which showed 33 (91.7%) aneurysms were completely occluded, 1 (2.8%) was improved, 1 (2.8%) was stable, and 1 (2.8%) was recanalized. Clinical follow-up (mean 29.6 months) was available for all survived patients, which showed 38 (95.0%) patients had favorable neurologic outcomes (mRS score 0–2), and 2 (5.0%) patients had poor neurologic outcomes. Conclusion: The use of LVIS stents is feasible, safe, and effective with glycoprotein IIb/IIIa inhibitor for the treatment of ruptured MCA aneurysms in the acute setting. Prospective, multicenter studies with larger sample sizes are still required to further evaluate the safety and long-term efficacy.
format Online
Article
Text
id pubmed-7876053
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-78760532021-02-12 Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device Xue, Gaici Zhou, Yu Liu, Peng Zuo, Qiao Yang, Pengfei Fang, Yibin Li, Qiang Zhao, Rui Xu, Yi Hong, Bo Huang, Qinghai Liu, Jianmin Front Neurol Neurology Objective: Stenting in ruptured middle cerebral artery (MCA) aneurysms was reported with a high perioperative complication rate. However, the treatment devices and physician's experience have continued to evolve. We performed this retrospective study to evaluate the safety and efficacy of LVIS stent-assisted coiling for ruptured MCA aneurysms. Methods: Patients with acutely ruptured MCA aneurysms treated between November 2014 and October 2019 were retrospectively reviewed. Clinical and angiographic data of those treated with LVIS stents were collected from a prospectively maintained database. Results: A total of 40 patients with 40 ruptured MCA aneurysms were enrolled, which comprised 26.3% (40/152) of all the ruptured MCA aneurysms at the same time. All stents were successfully deployed except for one (2.5%), which had a poor stent opening. Ischemic procedure-related complications were encountered in three patients (7.5%). One patient died of complications related to high-grade SAH on admission. Follow-up (mean 15.9 months) angiography was performed for 36 patients, which showed 33 (91.7%) aneurysms were completely occluded, 1 (2.8%) was improved, 1 (2.8%) was stable, and 1 (2.8%) was recanalized. Clinical follow-up (mean 29.6 months) was available for all survived patients, which showed 38 (95.0%) patients had favorable neurologic outcomes (mRS score 0–2), and 2 (5.0%) patients had poor neurologic outcomes. Conclusion: The use of LVIS stents is feasible, safe, and effective with glycoprotein IIb/IIIa inhibitor for the treatment of ruptured MCA aneurysms in the acute setting. Prospective, multicenter studies with larger sample sizes are still required to further evaluate the safety and long-term efficacy. Frontiers Media S.A. 2021-01-28 /pmc/articles/PMC7876053/ /pubmed/33584524 http://dx.doi.org/10.3389/fneur.2020.631745 Text en Copyright © 2021 Xue, Zhou, Liu, Zuo, Yang, Fang, Li, Zhao, Xu, Hong, Huang and Liu. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Xue, Gaici
Zhou, Yu
Liu, Peng
Zuo, Qiao
Yang, Pengfei
Fang, Yibin
Li, Qiang
Zhao, Rui
Xu, Yi
Hong, Bo
Huang, Qinghai
Liu, Jianmin
Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device
title Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device
title_full Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device
title_fullStr Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device
title_full_unstemmed Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device
title_short Endovascular Treatment of Ruptured Middle Cerebral Artery Aneurysms With a Low-Profile Visualized Intraluminal Support Device
title_sort endovascular treatment of ruptured middle cerebral artery aneurysms with a low-profile visualized intraluminal support device
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876053/
https://www.ncbi.nlm.nih.gov/pubmed/33584524
http://dx.doi.org/10.3389/fneur.2020.631745
work_keys_str_mv AT xuegaici endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT zhouyu endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT liupeng endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT zuoqiao endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT yangpengfei endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT fangyibin endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT liqiang endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT zhaorui endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT xuyi endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT hongbo endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT huangqinghai endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice
AT liujianmin endovasculartreatmentofrupturedmiddlecerebralarteryaneurysmswithalowprofilevisualizedintraluminalsupportdevice