Pipeline embolization device in treating middle cerebral artery aneurysms: a single-center experience in 69 consecutive patients.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY Neuroradiology Pub Date : 2025-05-01 Epub Date: 2025-04-07 DOI:10.1007/s00234-025-03606-0

Haoyu Zhu, Jiarui Zhang, Lian Liu, Chao Ma, Yuzhou Chang, Yuqi Song, Xiguang Fu, Longhui Zhang, Yupeng Zhang, Chuhan Jiang, Shikai Liang

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Abstract

Purpose: The pipeline embolization device (PED) has been established as an effective treatment option for aneurysms within its designated indications. Recently, its off-label applications, including treating middle cerebral artery (MCA) aneurysms, have increased. This study augmented the current literature by examining the outcomes of PED utilization for MCA aneurysms.

Methods: We collected data from consecutive patients with MCA aneurysms treated with PED between June 2016 and December 2021. Particularly, we collected data on patient demographics, aneurysm characteristics, procedural details, perioperative complications, and clinical and angiographic follow-up results.

Results: A total of 69 patients (mean age 47.4 years; 42.0% female) with MCA aneurysms who underwent PED treatment were included in this study. Among these, 5 aneurysms had ruptured previously, and 10 patients had previously undergone open surgery or received endovascular treatment. In the last angiographic follow-up, conducted at a mean of 19.0 ± 13.5 months, 44 of 56 (78.6%) aneurysms achieved complete occlusion. Ten (17.9%) and three (5.4%) patients exhibited in-stent stenosis and MCA occlusion, respectively. During a mean clinical follow-up period of 35.1 months, 10 of 63 patients (15.8%) experienced major procedure-related complications, including 2 hemorrhagic (3.2%) and 8 ischemic (12.7%) events.

Conclusion: PED is a viable treatment for MCA aneurysms, particularly those with fusiform and wide-necked characteristics that pose challenges for traditional open surgery. PED shows favorable clinical outcomes and occlusion rates and presents a notable risk of complications and in-stent restenosis. Therefore, careful patient selection is crucial when using PEDs to treat MCA aneurysms.

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用于治疗大脑中动脉动脉瘤的管道栓塞装置：单中心连续治疗 69 名患者的经验。

目的：管道栓塞装置（PED）已被确立为在其指定适应症内治疗动脉瘤的有效选择。最近，它的适应症外应用，包括治疗大脑中动脉（MCA）动脉瘤，有所增加。本研究扩充了现有文献，探讨了使用PED治疗MCA动脉瘤的结果。方法：我们收集了2016年6月至2021年12月期间连续接受PED治疗的MCA动脉瘤患者的数据。特别地，我们收集了患者人口统计学、动脉瘤特征、手术细节、围手术期并发症以及临床和血管造影随访结果的数据。结果：共69例患者，平均年龄47.4岁；本研究纳入了接受PED治疗的MCA动脉瘤患者（42.0%女性）。其中5例动脉瘤曾破裂，10例患者曾行开放手术或血管内治疗。在最后一次血管造影随访中，平均19.0±13.5个月，56个动脉瘤中有44个（78.6%）完全闭塞。10例（17.9%）和3例（5.4%）患者分别出现支架内狭窄和MCA闭塞。在平均35.1个月的临床随访期间，63例患者中有10例（15.8%）出现了主要的手术相关并发症，包括2例出血性（3.2%）和8例缺血性（12.7%）事件。结论：PED是一种可行的治疗MCA动脉瘤的方法，特别是那些具有梭状和宽颈特征的动脉瘤，这给传统的开放手术带来了挑战。PED具有良好的临床结果和闭塞率，但存在明显的并发症和支架内再狭窄风险。因此，在使用ped治疗MCA动脉瘤时，仔细选择患者是至关重要的。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.