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在Woven EndoBridge器件栓塞后治疗残留和复发性动脉瘤:系统性审查和元分析

Vinay Jaikumar^1,2, Jaims Lim^1,2, Matthew D Moser^1,2

¹Department of Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.

Journal of neurointerventional surgery

|January 27, 2025

概括

编织EndoBridge (WEB) 装置动脉瘤的再处理显示出良好的安全性,但适度的闭塞. 需要进行进一步的研究,以确定观察性管理是否足以在WEB栓塞后治疗残留或复发性动脉瘤.

科学领域:

内血管神经外科手术血管内血管神经外科
脑血管疾病脑血管疾病
医疗器械技术医疗器械技术

背景情况:

早期编织EndoBridge (WEB) 设备研究报告了高充分封闭率 (80-90%) 但低完全封闭率 (40-55%).
关于是否需要对残留或复发性动脉瘤进行重复治疗以防止破裂存在不确定性.

研究的目的:

系统地审查和元分析之前用WEB设备治疗的动脉瘤的再治疗后的闭塞和并发症率.
评估各种再处理策略的有效性和安全性.

主要方法:

在PubMed和EMBASE的系统性文献搜索中,寻找关于重新治疗WEB治疗的动脉瘤的研究.
包括报告策略和结果的研究;提取患者和动脉瘤特征,结果和并发症.
对三个或更多研究报告的变量进行的元分析.

主要成果:

分析了15项研究,其中包括220名接受了WEB治疗的动脉瘤患者.
平均随访时间为11.2个月;75.9%的患者表现出剩余的圆顶填充,主要是由于不完全封闭 (84.7%).
重复治疗实现了64.1%的完全闭塞,8.9%的血栓栓塞并发症和8%的设备相关并发症. 在82.5%的复发中使用了内血管管理.

结论:

在WEB栓塞后的复发性或残留性动脉瘤的重复治疗显示出出色的安全性和适度的闭塞结果.
由于缺乏关于观察管理结果的数据,人们质疑重新治疗的必要性.
血管内战略是安全和有效的后WEB复发,具有越来越大的作用.

关键词:

动脉瘤是一个动脉瘤.脑子脑子脑子脑子检查设备检查设备发生出血发生出血干预干预干预

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