Analysis of the efficacy of Pipeline in the treatment of unruptured vertebrobasilar artery dissecting aneurysms
Objective To investigate the safety and efficacy of Pipeline blood flow guidance device(PED)in the treatment of unrup-tured vertebrobasilar dissected aneurysms and the related factors affecting the complete healing of aneurysms.Methods Thirty-one patients with vertebra-basilar artery dissection aneurysm who received PED treatment in the Department of Neurosurgery in General Hospital of Northern Theater Command from March 2019 to March 2023 were selected as the study objects.The clinical prognosis of the patients was evaluated using the modified Rankin scale score.The degree of aneurysm healing was observed by digital subtraction angiography(DSA)images before and after surgery.The DSA images were evaluated by O'Kelly-Marotta rating scale,and the patients were divided into complete union group and incomplete union group according to whether the aneurysm was completely healed.The rel-evant clinical data of patients were collected,and the factors of complete aneurysm healing were analyzed by univariate analysis and multivariate Logistic regression.Results All patients successfully completed the operation,of which 17 cases were embolized by PED alone,and14 cases were embolized by PED and spring coil.Ischemic complications occurred in 4 cases(12.9%)of which 2 cases(6.5%)occurred perioperative ischemic complications,all of which were acute thrombosis and were treated with thrombolysis or thrombolysis.Postoperative recovery was satisfactory,and 2 cases(6.5%)occurred long-term ischemic complications after surgery.Hemorrhage complication occurred in 1 case(3.2%),which was rupture of aneurysm during operation.In the follow-up patients,21 cases of complete aneurysm healing were included in the complete union group and 10 cases of incomplete aneurysm healing were included in the incomplete union group.Univariate analysis showed that there were statistically significant differences in the proportion of patients with or without filling circle and with or without contrast agent in venous retention between the complete healing group and the incomplete healing group(P＜0.05).The results of multi-factor analysis showed that the filling circle and the venous retention pe-riod of contrast agent were the influencing factors for the complete healing of aneurysms(P＜0.05).Conclusion For posterior circu-lation dissection aneurysms,PED treatment has a high rate of aneurysm occlusion and good effect,but postoperative complications should not be ignored,clinical attention should be paid to prevention and treatment,combined with spring coil treatment is more condu-cive to aneurysm healing.
NETL
NSTL
万方数据
