Treatment of fusiform aneurysms with a pipeline embolization device: a multicenter cohort study,Journal of NeuroInterventional Surgery

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Treatment of fusiform aneurysms with a pipeline embolization device: a multicenter cohort study
Journal of NeuroInterventional Surgery ( IF 4.5 ) Pub Date : 2023-04-01 , DOI: 10.1136/neurintsurg-2021-018539
Mirzat Turhon _{1,

2} , Huibin Kang _{1,

2} , Mengxing Li _{1,

2} , Jian Liu _{1,

2} , Yisen Zhang _{1,

2} , Ying Zhang _{1,

2} , Jiliang Huang _{1,

2} , Bin Luo _{1,

2,

3} , Jianmin Liu ₄ , Hongqi Zhang ₅ , Tianxiao Li ₆ , Donglei Song ₇ , Yuanli Zhao ₃ , Sheng Guan ₈ , Axir Aximujiang ₉ , Aisha Maimaitili ₉ , Yunyan Wang ₁₀ , Wenfeng Feng ₁₁ , Yang Wang _{12,

13} , Jieqing Wan ₁₄ , Guohua Mao ₁₅ , Huaizhang Shi ₁₆ , Xiaolong Zhang ₁₇ , Yuxiang Gu ₁₈ , Xinjian Yang _{2,

19}

Affiliation

Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China.
Department of Interventional Neuroradiology, Beijing TianTan Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Neurosurgery, Peking University International Hospital, Beijing, People's Republic of China.
Department of Neurosurgery, Changhai Hospital, Shanghai, Shanghai, People's Republic of China.
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Neurosurgery, Zhengzhou University People's Hospital, Zhengzhou, Henan, People's Republic of China.
Department of Neurosurgery, Shanghai Donglei Brain Hospital, Shanghai, People's Republic of China.
Department of Intervention Neuroradiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, People's Republic of China.
Department of Neurosurgery, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, People's Republic of China.
Department of Neurosurgery, Qilu Hospital, Shandong University, Jinan, Shandong, People's Republic of China.
Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, People's Republic of China.
Department of Neurosurgery, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.
Department of Neurosurgery, Beijing ChaoYang Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Neurosurgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, People's Republic of China.
Department of Neurosurgery, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, People's Republic of China.
Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China.
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, Shanghai, People's Republic of China.
Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, Shanghai, People's Republic of China
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China

Background Intracranial fusiform aneurysms are less common than saccular aneurysms, but are associated with higher mortality and morbidity. We conducted this study to determine the safety and efficacy of the pipeline embolization device (PED) to treat intracranial fusiform aneurysms. Methods This was a multicenter, retrospective, and observational study. Data for this study came from the PLUS study conducted from 2014 to 2019 across 14 centers in China. Univariate and multivariable logistic regression analyses were performed to evaluate predictors of the occlusion rate and complication. Results A total of 1171 consecutive patients with 1322 intracranial aneurysms participated in this study. Among the participants, 104 patients with 109 fusiform aneurysms were eligible for this analysis (mean age 49 years, 36.5% women, aneurysm mean size 14.7 mm, 55% in the posterior circulation, and 6% in the basilar artery). Mean follow-up time was 9.0 months (range 3–36 months). The last DSA angiographic follow-up was available for 85 patients, and 58 aneurysms (68.2%) were completely occluded. The overall complication rate and mortality were 17.3% and 2.8%, respectively. Multivariate analysis demonstrated that age (OR=1.007, p=0.037) and cerebral atherosclerosis (OR=1.441, p=0.002) were associated with incomplete occlusion of fusiform aneurysms after PED treatment. Conclusion PEDs may be an effective treatment for intracranial fusiform aneurysms, with a favorable occlusion rate. However, because these treatments have a relatively high rate of complications, PED treatment for fusiform aneurysms should be carefully and strictly controlled. Our analysis showed that PEDs with adjunctive coiling did not significantly improve the occlusion rate of fusiform aneurysms. Data are available upon reasonable request. Not applicable.

更新日期：2023-03-14

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