Pipeline栓塞装置治疗颅内未破裂动脉瘤的短期疗效

Short-term results following treatment of unruptured intracranial aneurysms with Pipeline embolization device

目的 探讨Pipeline栓塞装置（PED）治疗颅内未破裂动脉瘤的安全性及短期疗效.方法 回顾性分析首都医科大学宣武医院神经外科2014年10月至2016年6月使用PED治疗42例颅内未破裂动脉瘤患者的临床资料,并进行短期临床疗效总结和影像学随访评估.结果 42例患者的44个动脉瘤共放置49枚PED装置,其中42个动脉瘤术后即刻造影显示瘤腔内对比剂滞留,另外2个动脉瘤术后仍可见对比剂充盈.4例出现围手术期并发症.接受影像学随访的31例患者共32个动脉瘤,随访时间为2 ～12个月,平均（6.6＆#177;1.9）个月,动脉瘤完全闭塞24个（24/32,75％）,近全闭塞6个（6/32,19％）,1个（1/32,3％）动脉瘤未闭塞,1个（1/32,3％）动脉瘤复查发现颈内动脉闭塞.结论 初步应用PED栓塞颅内未破裂动脉瘤安全有效,但远期疗效有待于进一步研究.

Objective To present preliminary experience and short-term safety and efficacy of pipeline embolization device （PED） for endovascular treatment of unruptured intracranial aneurysms.Methods A retrospective analysis of clinical data and short-term safety and efficacy was conducted on 42 patients who underwent endovascular treatment with PED at Neurosurgery Department of Xuanwu Hospital,Capital Medical University,from October 2014 to June 2016.Results A total of 42 patients with 44 intracranial aneurysms were treated with 49 PEDs during the study period.Retention of contrast agent in the aneurysm cavity was detected by immediate postoperative radiography for 42 aneurysms and contrast agent could still be observed following surgery in 2 other cases.Four patients had procedural complications.A total of 32 aneurysms of 31 patients were followed up for 2-12 （mean：6.6 ± 1.9） months.Majority of the aneurysms （24/32,75%） showed angiographic evidence of complete obliteration and 6 aneurysms （6/32,19%） demonstrated angiographic evidence of near complete obliteration.Conclusion It is suggested that use of PED may offer a safe and effective strategy for treatment of unruptured intracranial aneurysms.Larger prospective studies are needed to confirm those observations.