【摘 要】
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Objective: To establish the efficacy of flow diverters (Pipeline, Silk, P64, Surpass) in occluding aneurysms and the complications associated with it. Method: Data of 47 patients(8 men,39 women; mean
【出 处】
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中华放射学学术大会2016、中华医学会第23次全国放射学学术大会暨中华医学会第24次全国影像技术学术大会
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Objective: To establish the efficacy of flow diverters (Pipeline, Silk, P64, Surpass) in occluding aneurysms and the complications associated with it. Method: Data of 47 patients(8 men,39 women; mean age,64.4 years)between January 2014-May 2016 were collected retrospectively using CRISP software as well as patients clinical case notes.Elective patients were started on Dual antiplatelet therapy(aspirin and clopidogrel),whereas prasugrel(30-60mg)was administered at least two hours pre operatively. Result: Off the 47 patients, 26% of whom had recurrent aneurysms (previous failed surgical/ radiological treatment will be discussed) and 74% had presented to our institution with a new aneurysm that was not treated previously. About 96% of the aneurysms were in the anterior circulation and only 4% was in the posterior circulation. 76% of the patients had a successful complete occlusion on follow up (at 6 and 18 months post operatively); off those, Pipeline, Surpass, P64 achieved 80%, 70%, 75% occlusion rate respectively. Only 2% of the patients had a recurrent aneurysm on follow-up imaging. 15% of the patients had minor adverse event after the procedure, including a groin haematoma.? Conclusion: Flow diverters have revolutionised the manner in which aneurysms are treated by altering the hemodynamics at parent/ aneurysm sac, and as such resulting in gradual thrombosis over time (as opposed to coil embolisation) of the aneurysm sac. Indeed, Flow diverters enable us to manage previously untreated aneurysms safety including wide-neck aneurysms. Further comparative studies of different flow diverters are needed to address the use of flow diverters for other indication. This novel modality in treating aneurysms has reignited the essential need for further research to identify the safest and most effective manner to treat such patients.?
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