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Treatment of Intracranial Vertebral Artery Dissecting Aneurysms Using Pipeline Embolization Devices : A Multicenter Cohort Study

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机构: [1]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China [2]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [3]Changhai Hospital Affiliated to Naval Medical University, Shanghai, China [4]Xuanwu Hospital, Capital Medical University, Beijing, China [5]Zhengzhou University People’s Hospital, Zhengzhou, China [6]Shanghai Donglei Brain Hospital, Shanghai, China [7]Peking University International Hospital, Beijing, China [8]First Affiliated Hospital of Xinjiang Medical University, Urumqi, China [9]Qilu Hospital of Shandong University, Jinan, China [10]Nanfang Hospital, Southern Medical University, Guangzhou, China [11]Beijing Chaoyang Hospital, Capital Medical University, Beijing, China [12]Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China [13]Second Affiliated Hospital of Nanchang University, Nanchang, China [14]First Affiliated Hospital of Harbin Medical University, Harbin, China [15]First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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关键词: Flow diverter Dissecting aneurysm Vertebral artery Posterior inferior cerebellar artery Complications

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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.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.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).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.http://www.gov . Unique identifier: NCT03831672.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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出版当年[2022]版:
大类 | 3 区 医学
小类 | 3 区 核医学 3 区 临床神经病学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 核医学
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出版当年[2021]版:
Q3 CLINICAL NEUROLOGY Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
最新[2023]版:
Q2 CLINICAL NEUROLOGY Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者机构: [1]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China [2]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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通讯机构: [1]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China [2]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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