[1]张莹,罗斌,康慧斌,等.Pipeline栓塞装置治疗大脑中动脉动脉瘤的疗效：一项回顾性多中心研究[J].中国临床神经外科杂志,2023,28(04):225-229.[doi:10.13798/j.issn.1009-153X.2023.04.001]
　ZHANG Ying,LUO Bin,KANG Hui-bin,et al.Clinical efficacy of pipeline embolization devices for patients with middle cerebral artery aneurysms: a retrospective multicenter study[J].,2023,28(04):225-229.[doi:10.13798/j.issn.1009-153X.2023.04.001]
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Pipeline栓塞装置治疗大脑中动脉动脉瘤的疗效：一项回顾性多中心研究()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年04期
页码:
225-229
栏目:
论著
出版日期:
2023-04-30

文章信息/Info

Title:
Clinical efficacy of pipeline embolization devices for patients with middle cerebral artery aneurysms: a retrospective multicenter study
文章编号:
1009-153X（2023）04-0225-05
作者:
张莹; 罗斌; 康慧斌; 刘健; 张义森; 杨新健; 张鸿祺; 李天晓; 买买提力·艾沙; 毛国华; 宋冬雷; 王云彦; 冯文峰; 汪阳; 史怀璋; 万杰清; 刘建民; 管生; 赵元立; 王超
100070北京，北京市神经外科研究所神经介入室/首都医科大学附属北京天坛医院神经外科（张莹、刘健、张义森、杨新健、王超）；102200北京，北京大学国际医院神经外科（罗斌、赵元立）；510515广州，南方医科大学南方医院神经外科（康慧斌、冯文峰）；100053北京，首都医科大学宣武医院神经外科（张鸿祺）；450003郑州，河南省人民医院介入科（李天晓）；841100乌鲁木齐，新疆医科大学第一附属医院神经外科（买买提力?艾沙）；330006南昌，南昌大学第二附属医院神经外科（毛国华）；201799上海，上海冬雷脑科医院神经外科（宋冬雷）；250012济南，山东大学齐鲁医院神经外科（王云彦）；330006南昌，南昌大学第一附属医院神经外科（汪阳）；150000哈尔滨，哈尔滨医科大学附属第一医院神经外科（史怀璋）；......
Author(s):
ZHANG Ying; LUO Bin; KANG Hui-bin; LIU Jian; ZHANG Yi-sen; YANG Xin-jian; ZHANG Hong-qi; LI Tian-xiao; MAIMAITILI Aisha; MAO Guo-hua; SONG Dong-lei; WANG Yun-yan; FENG Wen-feng; WANG Yang; SHI Huai-zhang; WAN Jie-qing; LIU Jian-min; GUAN Sheng; ZHAO Yuan-li; WANG Chao
1.Department of Interventional Neuroradiology, Beijing Neurosurgical Institute & Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; 2.Department of Neurosurgery, Peking University International Hospital, Beijing 102200, China; 3.Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; 4.Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;......
关键词:
颅内动脉瘤; 大脑中动脉; 血流导向装置; pipeline栓塞装置（PED）; 疗效
Keywords:
Intracranial aneurysm;  Middle cerebral artery;  Pipeline embolization device (PED);  Clinical efficacy
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2023.04.001
文献标志码:
R743.9;R815.2
摘要:
目的 探讨pipeline栓塞装置（PED）治疗大脑中动脉（MCA）动脉瘤的临床效果。方法 回顾性分析2014年11月至2019年10月我国14个临床中心采用PED治疗的33例MCA动脉瘤的临床资料、影像学资料和随访资料。结果 33例共39个动脉瘤，使用37个PED。33例完成临床随访，30例（36个动脉瘤）完成影像随访；随访时间4~22个月，平均（10.6±6.3）个月；动脉瘤完全或近全闭塞30个（83.3%，30/36）；相对于单纯PED治疗组（71.4%），PED辅助弹簧圈栓塞组动脉瘤闭塞率更高（100%；P=0.031）；预后不良（mRS评分>2分）3例（9.1%），预后良好（mRS评分≤2分）30例（90.9%）；术后并发症发生率为24.2%（8/33），术前规律服用双抗药物3 d以上病人术后并发症发生率明显低于未规律服用双抗药物的病人（P=0.033）。结论 MCA动脉瘤可以采用PED治疗，疗效较满意。对于直径大、形态不规则的MCA动脉瘤，可使用PED结合弹簧圈栓塞治疗以获得更高的闭塞率。术前、术后应规范应用双抗药物以减少缺血、出血并发症。
Abstract:
Objective To investigate the clinical efficacy of pipeline embolization devices (PED) for patients with middle cerebral artery (MCA) aneurysms. Methods The clinical data, imaging data and follow-up data of 33 patients with MCA aneurysms treated with PED in 14 clinical centers from November 2014 to October 2019 were retrospectively analyzed. Results Thirty-seven PEDs were used in 33 patients with 39 MCA aneurysms. Clinical follow-up was completed in 33 patients and imaging follow-up was completed in 30 patients (36 aneurysms). The follow-up time ranged from 4 to 22 months, with an average of (10.6±6.3) months. Complete or near complete occlusion of aneurysms were achieved in 30 aneurysms (83.3%, 30/36). Compared with the patients treated with PED alone [71.4%(15/21)], the occlusion rate of aneurysms was significantly higher in the patients treated with PED-assisted coil embolization [100%(15/15); P=0.031]. Thirty patients (90.9%) had good prognoses (mRS score ≤2), and 3 (9.1%) had poor prognoses (mRS score >2). The incidence of postoperative complications was 24.2% (8/33), and patients who received dual antiplatelet therapy for more than 3 days before surgery had a significantly lower incidence of postoperative complications (3.4%) compared to those who did not (50%; P=0.033). Conclusions MCA aneurysms can be treated with PED and the effectiveness is good. For MCA aneurysms with large diameter and irregular morphology, PED combined with coil embolization can obtain a higher occlusion rate. Preoperative and postoperative dual antiplatelet therapies are recommended to decrease ischemia and bleeding complications.

参考文献/References:

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备注/Memo

备注/Memo:
（2022-11-02收稿，2023-02-14修回）
基金项目：国家自然科学基金（82072036；82272092）；首发重点攻关项目（2022-1-2041）；北京市医院管理中心登峰人才计划（DFL20220504）
共同第一作者：张　莹、罗　斌
通讯作者：王　超，E-mail：15736995211@163.com
更新日期/Last Update: 2022-04-30