Flow-diverting stents for the treatment of unruptured distal anterior cerebral artery aneurysms: analysis of the CRETA Registry.

IF 4.5 1区医学 Q1 NEUROIMAGING Journal of NeuroInterventional Surgery Pub Date : 2025-01-27 DOI:10.1136/jnis-2024-022315

Luca Scarcia, Frédéric Clarençon, Adam A Dmytriw, Eimad Shotar, Kevin Premat, Pascal Jabbour, Stavropoula I Tjoumakaris, Reid Gooch, Marios-Nikos Psychogios, Nikolaos Ntoulias, Peter B Sporns, Ajit S Puri, Jasmeet Singh, Anna Luisa Kuhn, Ameer E Hassan, Oktay Algin, Markus A Möhlenbruch, Sophia Hohenstatt, Riccardo Russo, Mauro Bergui, Oded Goren, Matthew J Kole, Nourou Dine Adeniran Bankole, Richard Bibi, Gregoire Boulouis, Takeshi Morimoto, Fumihiro Sakakibara, Raoul Pop, Ciprian Juravle, Joanna Wk Ho, Angel Ferrario, Virginia Pujol Lereis, Jared Cooper, Chirag D Gandhi, Giancarlo Salsano, Lucio Castellan, Arianna Camilli, Arturo Consoli, Alessandro Sgreccia, Eytan Raz, Charlotte Chung, Julien Burel, Chrysanthi Papagiannaki, Umair Rasheed, Khawaja Muhammad Baqir Hassan, Tao Hong, Zhe Ji, Riitta Rautio, Matias Sinislao, Maria Ruggiero, Elvis Lafe, Valerio Da Ros, Luigi Bellini, Joseph D Gabrieli, Giacomo Cester, Michael R Levitt, Kate T Carroll, Zack A Abecassis, Antonio Armando Caragliano, Sergio L Vinci, Guillaume Bellanger, Christophe Cognard, Gaultier Marnat, Lisa Saleille, Nicola Limbucci, Francesco Capasso, Mariangela Piano, Claudia Rollo, Alexis Guedon, Francesco Arpaia, Andrea Romi, Fortunato Di Caterino, Alessandra Biondi, Erwah Kalsoum, Vyval Mykola, Adrien Guenego, Aman B Patel, Vitor M Pereira, Alessandro Pedicelli, Andrea Maria Alexandre

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Abstract

Background: Data about the safety and the efficacy of flow diversion for distal anterior cerebral artery (DACA) aneurysms are limited. We present the largest multicenter analysis evaluating the outcomes of flow diversion in unruptured DACA aneurysm treatment.

Methods: Databases from 39 centers were retrospectively reviewed for unruptured DACA aneurysms treated with flow-diverting stents. Demographics, clinical presentation, radiographic characteristics, procedural complications, and outcomes were assessed.

Results: A total of 168 patients with 168 unruptured DACA aneurysms were treated between January 2018 and December 2022. One hundred and twenty-five were women (74.4%) and the median age was 61 (IQR 52-67) years. The most common morphology was saccular (91.7%), with branch involvement in 61.9% of cases. Median parent vessel diameter was 1.9 mm (IQR 1.7-2.2) and stents were successfully deployed in 99.4% of cases. In 96.4% a single stent was implanted, while 3.6% of cases required two stents. Median imaging follow-up was 16.5 (IQR 7-24) months. At last follow-up the rate of occlusion (O'Kelly-Marotta scale C or D) was 82.1%. Symptomatic thromboembolic or hemorrhagic complications occurred in 5.3% of patients and the mortality rate was 0.6%. The rate of retreatment was 1.2%.

Conclusions: Flow-diverting stents are a reasonably safe and effective treatment option for unruptured DACA aneurysms.

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血流转移支架治疗未破裂的大脑前远端动脉瘤：CRETA登记的分析。

背景：关于血流转移治疗大脑远前动脉（DACA）动脉瘤的安全性和有效性的数据有限。我们提出了一项最大的多中心分析，评估了在未破裂的DACA动脉瘤治疗中分流的结果。方法：回顾性分析来自39个中心的数据库，对使用分流支架治疗的未破裂的DACA动脉瘤进行分析。评估了人口统计学、临床表现、影像学特征、手术并发症和结果。结果：2018年1月至2022年12月，共治疗168例未破裂的DACA动脉瘤。125例为女性（74.4%），中位年龄为61岁（IQR 52-67）。最常见的形态为囊状（91.7%），61.9%的病例伴分支受累。中位母血管直径为1.9 mm (IQR为1.7-2.2)，99.4%的病例成功放置支架。96.4%的患者只植入了一个支架，3.6%的患者需要两个支架。中位影像学随访时间为16.5个月（IQR 7-24）。最后随访时闭塞率（O'Kelly-Marotta评分C或D）为82.1%。症状性血栓栓塞或出血性并发症发生率为5.3%，死亡率为0.6%。再处理率为1.2%。结论：对于未破裂的DACA动脉瘤，分流支架是一种安全有效的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of NeuroInterventional Surgery NEUROIMAGING-SURGERY

CiteScore

9.50

自引率

14.60%

发文量

291

审稿时长

4-8 weeks

期刊介绍： The Journal of NeuroInterventional Surgery (JNIS) is a leading peer review journal for scientific research and literature pertaining to the field of neurointerventional surgery. The journal launch follows growing professional interest in neurointerventional techniques for the treatment of a range of neurological and vascular problems including stroke, aneurysms, brain tumors, and spinal compression.The journal is owned by SNIS and is also the official journal of the Interventional Chapter of the Australian and New Zealand Society of Neuroradiology (ANZSNR), the Canadian Interventional Neuro Group, the Hong Kong Neurological Society (HKNS) and the Neuroradiological Society of Taiwan.