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28.06.2023 | Original Article

Treatment of Intracranial Vertebral Artery Dissecting Aneurysms Using Pipeline Embolization Devices

A Multicenter Cohort Study

verfasst von: Ying Zhang, Fujunhui Zhang, Mirzat Turhon, Jiliang Huang, Mengxing Li, Qichen Peng, Zhaoxu Zheng, Jian Liu, Yisen Zhang, Jianmin Liu, Hongqi Zhang, Tianxiao Li, Donglei Song, Yuanli Zhao, Maimaitili Aisha, Yunyan Wang, Wenfeng Feng, Yang Wang, Jieqing Wan, Guohua Mao, Huaizhang Shi, Sheng Guan

Erschienen in: Clinical Neuroradiology | Ausgabe 4/2023

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Abstract

Purpose

Intracranial vertebral artery dissecting aneurysm (IVADA) is a rare type of aneurysm with high morbidity and mortality. Recently, the application of pipeline embolization devices (PEDs) has been extended to IVADAs. Here, we aim to investigate the safety and effectiveness of PEDs for IVADAs.

Method

We retrospectively reviewed the PLUS database to identify patients who had IVADAs and were treated with PEDs from 2014 to 2019 at 14 centers across China. Data including patient and aneurysm characteristics, procedure details, angiographic and clinical results, relationship with the ipsilateral posterior inferior cerebellar artery (PICA), and patency of the PICA following PED coverage were analyzed.

Results

In this study 52 consecutive patients with 52 IVADAs were included. The mean age was 52.33 years and 82.7% were male. With a median follow-up of 10.5 months, the complete occlusion rate was 93.8% (45/48) and no recurrence or in-stent stenosis was detected. The total postoperative complication rate and mortality were 11.5% and 1.9%, respectively. Complications occurred in 9.6% (5/52) of patients within 30 days after the operation, including ischemic stroke in 3 and hemorrhagic stroke in 2. Another patient suffered an ischemic stroke at follow-up, 78.8% (41/52) PICAs were covered by PEDs, 1 case (2.4%) had a functional disability due to PICA occlusion, while 39.0% (16/41) had reduced flow during follow-up but hardly caused any obvious neurological deficits. Patients with IVADA involving PICA had a trend towards more complications (66.7% vs. 51.1%; P = 1).

Conclusion

Treating IVADAs with PEDs may be a safe and effective option, with favorable clinical and angiographic outcomes; however, complications associated with this treatment should not be ignored.

Registration

http://www.clinicaltrials.gov. Unique identifier: NCT03831672

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Titel: Treatment of Intracranial Vertebral Artery Dissecting Aneurysms Using Pipeline Embolization Devices
A Multicenter Cohort Study
verfasst von: Ying Zhang
Fujunhui Zhang
Mirzat Turhon
Jiliang Huang
Mengxing Li
Qichen Peng
Zhaoxu Zheng
Jian Liu
Yisen Zhang
Jianmin Liu
Hongqi Zhang
Tianxiao Li
Donglei Song
Yuanli Zhao
Maimaitili Aisha
Yunyan Wang
Wenfeng Feng
Yang Wang
Jieqing Wan
Guohua Mao
Huaizhang Shi
Sheng Guan
Publikationsdatum: 28.06.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Neuroradiology / Ausgabe 4/2023
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI: https://doi.org/10.1007/s00062-023-01318-7

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Treatment of Intracranial Vertebral Artery Dissecting Aneurysms Using Pipeline Embolization Devices

A Multicenter Cohort Study