| Background and purpose:Flow diverter(FD)is a new endovascular treatment device for intracranial aneurysm(IA).China has only been using FD since 2014,and our hospital was the first to use FD in Jiangxi province in 2015.The safety and efficacy of FD in our center were evaluated to demonstrate the quality of neurointerventional treatment in the region and to summarize the experience.Aneurysm Flow was used to evaluate the blood flow velocity in the aneurysm sac before and after FD placement on a 2D-DSA sequence.One study found that the threshold of mean aneurysm amplitude ratio(MAFA-R)can be used as a predictor of aneurysm occlusion.The purpose of this study was mainly to evaluate the safety and efficacy of FD for IA in our center and to summarize the treatment experience.Secondly,the Aneurysm Flow was used to compare and evaluate the effectiveness between PED and Tubridge in the treatment of IA.Methods:Clinical,imaging and follow-up data were collected from December 2015 to September 2020 for all IA patients treated with FD at the First Affiliated Hospital of Nanchang University.MAFA-R was calculated using Aneurysm Flow on DSA images immediately after FD placement(Before the coil embolizes).Patients were followed up by telephone and inpatient visits from 3 to 9 months postoperatively,and prognosis was assessed using the modified Rankin Scale score(m RS).DSA imaging was performed on patients at 6 months postoperatively,and imaging findings of aneurysm occlusion were evaluated by OKM grading.Factors independently associated with the occurrence of aneurysm occlusion rate were analyzed using appr-opriate statistical methods.Results:1.Data of a total of 76 patients(83 aneurysms)with a male to female ratio of 20:56 and a mean age of 54.5±9.7 years were included.There were 43 cases(51.8%)of small or moderate aneurysms,35 cases(42.2%)of large aneurysms,and 5 cases(6.0%)of giant aneurysms.2.40 aneurysms completed short-term 3 to 9(6.3±1.1)months DSA follow-up,of which 28(70.0%,28/40)were completely occluded and 12(30%,12/40)were incompletely occluded.9 aneurysms completed medium to long-term 9 to 30(17.4±6.5)months DSA follow-up,of which 7(77.8%,7/9)were completely occluded and 2(22.2%,2/9)were incompletely occluded.77.8%,7/9)and 2 incomplete occlusions(22.2%,2/9).A total of 76 patients were followed up at 6 months(± 3 months)after surgery and m RS score: 0 in 68 cases(89.5%),1 in 6 cases(7.9%),and 2 in 2 cases(2.6%).3.2 patients(2.6%)had postoperative hemorrhagic complications,including ipsilateral caudate nucleus hemorrhage in 1 patient on the first postoperative day and subarachnoid hemorrhage and ventricular hemorrhage in 1 patient on the first postoperative day.5 patients(6.6%)had ischemic complications,including contralateral limb weakness in 3 patients,impaired environmental interpretation in 1 patient,and 1 patient with preoperative the symptoms were blurred vision with left nasal visual field defect,and outpatient reexamination 1 month after surgery suggested blindness in the left eye.4.Multivariable analysis showed that aneurysm size(≥10 mm)(P=0.045)was a risk factor for incomplete occlusion of the aneurysm.5.A total of 19 patients(11 in the PED group and 8 in the Tubridge group)successfully calculated the MAFA-R.Statistical analysis revealed no statistically significant difference in the MAFA-R between the two groups(P=0.351).Conclusion:1.The short-term follow-up of PED and Tubridge for intracranial aneurysm in our center has a high cure rate,low complication rate,and is a safe and effective treatment method.2.The analysis of the follow-up results showed that when the maximum diameter of the aneurysm is ≥10 mm,it is a risk factor for incomplete occlusion of the aneurysm.3.There was no significant difference in MAFA-R between the PED and Tubridge groups,suggesting that the flow-directing ability of the two types of FD is close. |
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