对后部循环内动脉瘤的流量转移:系统性审查和元分析
Anderson Brito1, Leonardo Cruz-Criollo1, Milagros Galecio-Castillo1
1Neurology, University of Iowa Health Care, Iowa City, Iowa, USA.
Journal of neurointerventional surgery
|April 23, 2025
概括
流量转移器 (FD) 为后部循环动脉瘤提供适度的阻塞,但存在风险. 由于血栓栓塞事件和死亡率较高,仔细选择患者至关重要.
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:
- 后部循环动脉瘤具有更高的破裂风险.
- 流量转移器 (FD) 已在内动脉瘤中确立,但在后部循环中研究较少.
- 这一元分析评估了FD对后部循环动脉瘤的安全性和有效性.
研究的目的:
- 评估流量转移器在实现动脉瘤阻塞后循环中的有效性.
- 确定转流器的安全性,包括血栓塞栓事件和死亡率.
- 分析影响结果的因素,如动脉瘤形态学.
主要方法:
- 系统的文献搜索到2024年10月.
- 包括42项涉及1698名患者和1760名后部循环动脉瘤的研究.
- 使用随机效应模型进行封闭率,血栓塞栓事件,死亡率和功能结果的聚合分析.
主要成果:
- 总体而言,完全闭塞率为72.73%,脊椎动脉动脉瘤为47.6%.
- 血栓塞栓事件和死亡率的汇总率分别为11.70%和8.07%.
- 在状多利切切动脉瘤中观察到较低的闭塞率 (48.29%).
结论:
- 流量转移器通常对后部循环动脉瘤有充分的阻塞,但不包括 dolichoectatic-fusiform 亚型.
- 使用FD与血栓栓塞事件,死亡率和再治疗率的增加有关.
- 仔细的患者选择对于优化后循环中FD的结果至关重要.
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