Multiple telescopic stenting versus single flow diverter for the treatment of vertebral artery dissecting aneurysm.

Min-Seok Woo, Wonsoo Son, Dong-Hun Kang, Jaechan Park, Myungsoo Kim
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Abstract

Objective: Reconstruction methods, including stent-assisted coiling, multiple telescopic stents, and flow diverters, are preferred modalities for the treatment of unruptured vertebral artery dissecting aneurysms (VADAs). We aimed to compare the clinical outcomes between two reconstructive flow diversion techniques: single flow diverter (FD) device and multiple telescopic stenting (TS).

Methods: We retrospectively reviewed the clinical data of 39 patients with unruptured VADAs. Of these, 17 patients were treated with multiple TS and 22 with a single FD device. Aneurysm characteristics and clinical outcomes were compared between the two groups.

Results: All aneurysms included in this study successfully achieved flow diversion, regardless of the treatment modality and duration. However, the mean procedure duration to complete the diversion was shorter in the FD group. Subgroup analysis in TS group showed that there were no significant clinical differences between the low-profile visualized intraluminal support and Enterprise stents, except for the mean procedure duration.

Conclusions: Both the single FD and multiple TS methods showed excellent angiographic and clinical outcomes in the treatment of unruptured VADAs. However, single FD required a shorter procedure duration and was associated with faster achievement of complete flow diversion.

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治疗椎动脉剥脱性动脉瘤的多重伸缩支架与单一血流分流器。
目的:重建方法,包括支架辅助卷曲、多重伸缩支架和血流分流器,是治疗未破裂椎动脉夹层动脉瘤(VADA)的首选方法。我们旨在比较两种重建性血流分流技术:单个血流分流器(FD)装置和多个伸缩支架(TS)的临床疗效:我们回顾性分析了 39 例未破裂 VADA 患者的临床数据。方法:我们回顾性分析了 39 例未破裂 VADA 患者的临床数据,其中 17 例患者接受了多个 TS 治疗,22 例患者接受了单个 FD 装置治疗。比较了两组患者的动脉瘤特征和临床结果:结果:无论治疗方式和持续时间如何,本研究中的所有动脉瘤都成功实现了血流分流。然而,FD组完成血流分流的平均手术时间较短。TS组的亚组分析显示,除了平均手术时间外,低位可视腔内支撑与企业支架之间没有明显的临床差异:结论:单个 FD 和多个 TS 方法在治疗未破裂的 VADA 方面均显示出良好的血管造影和临床效果。然而,单个 FD 所需的手术时间更短,而且能更快地实现完全血流分流。
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