Tubridge血流导向装置治疗未破裂颅内动脉瘤的有效性和安全性

Efficacy and safety of Tubridge flow diverter in the treatment of unruptured intracranial aneurysms

目的探讨Tubridge血流导向装置(Tubridge flow diverter,TFD)治疗颅内未破裂动脉瘤的有效性和安全性。方法回顾性分析2021年7月至2023年7月临沂市人民医院神经外科使用TFD治疗的未破裂颅内动脉瘤患者的临床资料。术后随访采用改良Rankin量表(modified Rankin Scale,mRS)评估功能转归。至少术后3个月后行数字减影血管造影(digital subtraction angiography,DSA)随访,根据O'Kelly-Marotta(OKM)分级评估动脉瘤闭塞情况。结果共纳入52例患者(71个动脉瘤),成功置入54枚TFD。41例(78.8%)单纯置入TFD,11例(21.2%)TFD置入联合弹簧圈栓塞。1例患者术中发生支架内血栓形成,经过药物治疗后症状消失;各有2例术后发生出血和缺血并发症;随访期间无患者死亡。DSA随访34例共45个动脉瘤,随访时间(8.3±3.1)个月(范围3~15个月),其中OKM分级A级2个(4.4%),B级11个(24.4%),C级1个(2.2%),D级31个(68.9%)。最后一次随访时51例患者转归良好(mRS评分0~2分),1例转归不良(mRS评分4分)。结论TFD治疗颅内未破裂动脉瘤完全闭塞率较高,并发症发生率低。

Objective To investigate the efficacy and safety of Tubridge flow diverter(TFD)in the treatment of unruptured intracranial aneurysms(UIAs).Methods The clinical data of patients with UIAs treated with TFD in the Department of Neurosurgery,Linyi People's Hospital from July 2021 to July 2023 were retrospectively analyzed.The modified Rankin Scale(mRS)was used to evaluate functional outcomes during postoperative follow-up.Digital subtraction angiography(DSA)follow-up was performed at least 3 months after procedure,and the occlusion degree of the aneurysm was assessed with the O'Kelly-Marotta(OKM)grading system.Results A total of 52 patients(71 aneurysms)were included and 54 TFDs were successfully implanted.Forty-one patients(78.8%)were treated with TFD alone,while 11(21.2%)were treated with TFD combined with coil embolization.One patient experienced in-stent thrombosis during the procedure,and the symptoms disappeared after medical treatment.Postoperative hemorrhage and ischemic complications occurred in each 2 cases,respectively.No patient died during the follow-up period.DSA follow-up was performed on a total of 45 aneurysms in 34 patients.The followed-up time was 8.3±3.1 months(range,3-15 months),including 2 OKM grade A(4.4%),11 grade B(24.4%),1 grade C(2.2%),and 31 grade D(68.9%).At the last follow-up,51 patients had good outcomes(mRS score 0-2),and 1 patient had poor outcome(mRS score 4).Conclusion TFD for UIAs has a high complete occlusion rate and a low complication rate.