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The p48 Flow Modulation Device with Hydrophilic Polymer Coating (HPC) for the Treatment of Acutely Ruptured Aneurysms: Early Clinical Experience Using Single Antiplatelet Therapy.
CardioVascular and Interventional Radiology ( IF 2.9 ) Pub Date : 2020-02-06 , DOI: 10.1007/s00270-020-02418-4 Marta Aguilar-Perez 1, 2 , Victoria Hellstern 1 , Muhammad AlMatter 1 , Christina Wendl 3 , Hansjörg Bäzner 4 , Oliver Ganslandt 5 , Hans Henkes 1, 6
CardioVascular and Interventional Radiology ( IF 2.9 ) Pub Date : 2020-02-06 , DOI: 10.1007/s00270-020-02418-4 Marta Aguilar-Perez 1, 2 , Victoria Hellstern 1 , Muhammad AlMatter 1 , Christina Wendl 3 , Hansjörg Bäzner 4 , Oliver Ganslandt 5 , Hans Henkes 1, 6
Affiliation
BACKGROUND
Flow diversion (FD) remains a potential treatment option following aneurysmal subarachnoid hemorrhage (aSAH) when standard options may not be feasible. However, it should not be considered a first-line treatment due to the need for dual antiplatelet therapy (DAPT). The hydrophilic polymer coating on the p48MW flow diverter (HPC, phenox) is a surface modification that inhibits platelet adhesion. This study aims to report on our early single-center experience using the p48MW HPC (phenox) flow diverter with single antiplatelet therapy (SAPT) following an aSAH.
MATERIALS AND METHODS
We retrospectively identified all patients who had been treated with the p48MW HPC for aSAH under SAPT. All patients treated within 30 days following an aSAH were included. Any occurrence of thromboembolic and hemorrhagic complications was recorded alongside angiographic and clinical follow-up details.
RESULTS
Eight patients were identified. The mean interval between aSAH and FD was 6 days. Of the eight ruptured aneurysms, one was blister-like, one saccular, one mycotic, and the remaining five were dissecting aneurysms. Intraprocedural transient thrombus formation was observed in four patients (50%). Stent thrombosis was observed in one patient (12.5%) on day 3 with spontaneous recanalization after being switched onto DAPT. None of the aneurysms rebled after treatment. Two patients died due to cerebral vasospasm. Complete aneurysm occlusion had been achieved in all but one patient at angiographic follow-up (average 6 months).
CONCLUSIONS
This small series highlights the possibility and limitations of using the p48MW HPC with SAPT in ruptured aneurysms. Randomized trials with longer follow-up in larger cohorts are underway.
中文翻译:
具有亲水性聚合物涂层(HPC)的p48流量调节装置用于治疗急性破裂的动脉瘤:使用单一抗血小板治疗的早期临床经验。
背景技术当标准方案可能不可行时,在动脉瘤性蛛网膜下腔出血(aSAH)之后,分流(FD)仍是一种潜在的治疗方案。但是,由于需要双重抗血小板治疗(DAPT),因此不应将其视为一线治疗。p48MW分流器(HPC,phenox)上的亲水性聚合物涂层是抑制血小板粘附的表面改性剂。这项研究旨在报告我们在aSAH后使用p48MW HPC(phenox)分流器和单抗血小板治疗(SAPT)的早期单中心经验。材料与方法我们回顾性鉴定了所有在SAPT下接受过p48MW HPC治疗aSAH的患者。纳入所有在aSAH之后30天内接受治疗的患者。记录任何血栓栓塞和出血并发症以及血管造影和临床随访细节。结果确定了八例患者。aSAH和FD之间的平均间隔为6天。在8个破裂的动脉瘤中,有1个为水泡样,1个囊状,1个为霉菌性,其余5个为解剖性动脉瘤。在四名患者(50%)中观察到了术中瞬时血栓形成。在转用DAPT后第3天,有一名患者(12.5%)观察到了支架血栓形成,并自发进行了再通。治疗后没有动脉瘤再出血。2例患者因脑血管痉挛死亡。在血管造影随访中(平均6个月),除一名患者外,所有患者均实现了完全的动脉瘤闭塞。结论本小系列文章强调了将p48MW HPC与SAPT一起用于动脉瘤破裂的可能性和局限性。正在进行较大人群的长期随访的随机试验。
更新日期:2020-02-06
中文翻译:
具有亲水性聚合物涂层(HPC)的p48流量调节装置用于治疗急性破裂的动脉瘤:使用单一抗血小板治疗的早期临床经验。
背景技术当标准方案可能不可行时,在动脉瘤性蛛网膜下腔出血(aSAH)之后,分流(FD)仍是一种潜在的治疗方案。但是,由于需要双重抗血小板治疗(DAPT),因此不应将其视为一线治疗。p48MW分流器(HPC,phenox)上的亲水性聚合物涂层是抑制血小板粘附的表面改性剂。这项研究旨在报告我们在aSAH后使用p48MW HPC(phenox)分流器和单抗血小板治疗(SAPT)的早期单中心经验。材料与方法我们回顾性鉴定了所有在SAPT下接受过p48MW HPC治疗aSAH的患者。纳入所有在aSAH之后30天内接受治疗的患者。记录任何血栓栓塞和出血并发症以及血管造影和临床随访细节。结果确定了八例患者。aSAH和FD之间的平均间隔为6天。在8个破裂的动脉瘤中,有1个为水泡样,1个囊状,1个为霉菌性,其余5个为解剖性动脉瘤。在四名患者(50%)中观察到了术中瞬时血栓形成。在转用DAPT后第3天,有一名患者(12.5%)观察到了支架血栓形成,并自发进行了再通。治疗后没有动脉瘤再出血。2例患者因脑血管痉挛死亡。在血管造影随访中(平均6个月),除一名患者外,所有患者均实现了完全的动脉瘤闭塞。结论本小系列文章强调了将p48MW HPC与SAPT一起用于动脉瘤破裂的可能性和局限性。正在进行较大人群的长期随访的随机试验。