Objective: To investigate the safety and effectiveness of the Pipeline Flex embolization device(PFED) in the treatment of large and wide-necked aneurysms in the internal carotid artery(ICA). Methods: The clinical data...Objective: To investigate the safety and effectiveness of the Pipeline Flex embolization device(PFED) in the treatment of large and wide-necked aneurysms in the internal carotid artery(ICA). Methods: The clinical data of 78 cases of large and wide-necked aneurysms in the ICA treated with this Pipeline Flex embolization device in Shanghai Hospital of the Second Military Medical University and Southern Hospital of Southern Medical University from February 2017 to June 2018 were retrospectively analyzed. Results: A total of 66 cases were treated with a Pipeline Flex embolization device, 10 with a pipeline flex embolization device, and 2 with a double tubride stent(10 patients were treated with a pipeline stent-assisted coil embolization in; and 2 patients were treated with two pipeline stents). The patients were followed up for 3 to 18 months(average, 9.25 months). Among them, 63 cases had complete occlusion of the neck of the aneurysm(Raymondl Class I; MRS score 0; 80.8%). Aneurysms recurred in 12 cases(Raymondl Class Ⅱ; MRS score 1; 15.4%). Delayed ischemic complications were observed in 1 case(MRS score >2; 0.13%). There was 1 case of poor release of stent and 1 case of stent stenosis(0.13%). Conclusion: The treatment of large, wide-necked aneurysms in the ICA with PFED has a high total occlusion rate and good prognosis was better than coil embolization, but the placement of PFED still has some neurological complications.展开更多
目的评价主动脉腔内覆膜支架置人术（支架置入术）与开放手术治疗急性B型胸主动脉夹层（ acute type B aortic dissection,ATBAD）的疗效。方法系统检索Cochrane图书馆的临床对照试验中心注册库（Cochrane Central Register of Controll...目的评价主动脉腔内覆膜支架置人术（支架置入术）与开放手术治疗急性B型胸主动脉夹层（ acute type B aortic dissection,ATBAD）的疗效。方法系统检索Cochrane图书馆的临床对照试验中心注册库（Cochrane Central Register of Controlled Trials, CENTRAL）、MEDLINE .EMBASE .CINAHL.Web of Science. OpenSIGLE .National Technical Information Service（NTIS）和中国知网（CNKI）、中国生物文献数据库（CBM）、维普数据库（VIP）、万方数据库（WanFangData）里的主动脉腔内覆膜支架置入术和开放手术治疗急性B型主动脉夹层的临床对照试验。文献检索起止时间均为从建库到2011年1月18日。由研究人员根据Cochrane偏倚评价和GRADE系统推荐分级方法，对证据质量进行严格评价和资料提取，对符合质量标准的临床对照试验进行meta分析。统计学分析采用RevMan5．0软件和GRAED profiler 3．2．2软件。结果5个临床试验共318例患者纳入研究。GRADE评价分析发现30天病死率的证据质量是低级，其他结局均为极低级。急性B型主动脉夹层患者主动脉腔内覆膜支架置入术组与手术组治疗的短期病死率差异有统计学意义，OR0．19、95％CI[0．09，0．39]，P〈0．001，但围术期并发症和远期病死率两组比较差异无统计学意义，OR1．40、95％CI[0．24，8．18]。结论主动脉腔内覆膜支架置入术只能作为治疗急性B型主动脉夹层的一种选择，目前的证据尚不能证明其可完全替代开放手术。展开更多
文摘Objective: To investigate the safety and effectiveness of the Pipeline Flex embolization device(PFED) in the treatment of large and wide-necked aneurysms in the internal carotid artery(ICA). Methods: The clinical data of 78 cases of large and wide-necked aneurysms in the ICA treated with this Pipeline Flex embolization device in Shanghai Hospital of the Second Military Medical University and Southern Hospital of Southern Medical University from February 2017 to June 2018 were retrospectively analyzed. Results: A total of 66 cases were treated with a Pipeline Flex embolization device, 10 with a pipeline flex embolization device, and 2 with a double tubride stent(10 patients were treated with a pipeline stent-assisted coil embolization in; and 2 patients were treated with two pipeline stents). The patients were followed up for 3 to 18 months(average, 9.25 months). Among them, 63 cases had complete occlusion of the neck of the aneurysm(Raymondl Class I; MRS score 0; 80.8%). Aneurysms recurred in 12 cases(Raymondl Class Ⅱ; MRS score 1; 15.4%). Delayed ischemic complications were observed in 1 case(MRS score >2; 0.13%). There was 1 case of poor release of stent and 1 case of stent stenosis(0.13%). Conclusion: The treatment of large, wide-necked aneurysms in the ICA with PFED has a high total occlusion rate and good prognosis was better than coil embolization, but the placement of PFED still has some neurological complications.
文摘目的评价主动脉腔内覆膜支架置人术（支架置入术）与开放手术治疗急性B型胸主动脉夹层（ acute type B aortic dissection,ATBAD）的疗效。方法系统检索Cochrane图书馆的临床对照试验中心注册库（Cochrane Central Register of Controlled Trials, CENTRAL）、MEDLINE .EMBASE .CINAHL.Web of Science. OpenSIGLE .National Technical Information Service（NTIS）和中国知网（CNKI）、中国生物文献数据库（CBM）、维普数据库（VIP）、万方数据库（WanFangData）里的主动脉腔内覆膜支架置入术和开放手术治疗急性B型主动脉夹层的临床对照试验。文献检索起止时间均为从建库到2011年1月18日。由研究人员根据Cochrane偏倚评价和GRADE系统推荐分级方法，对证据质量进行严格评价和资料提取，对符合质量标准的临床对照试验进行meta分析。统计学分析采用RevMan5．0软件和GRAED profiler 3．2．2软件。结果5个临床试验共318例患者纳入研究。GRADE评价分析发现30天病死率的证据质量是低级，其他结局均为极低级。急性B型主动脉夹层患者主动脉腔内覆膜支架置入术组与手术组治疗的短期病死率差异有统计学意义，OR0．19、95％CI[0．09，0．39]，P〈0．001，但围术期并发症和远期病死率两组比较差异无统计学意义，OR1．40、95％CI[0．24，8．18]。结论主动脉腔内覆膜支架置入术只能作为治疗急性B型主动脉夹层的一种选择，目前的证据尚不能证明其可完全替代开放手术。
