Therapeutic effect of Pipeline embolization device in treatment of vertebral artery aneurysms
Objective To investigate the efficacy and safety of Pipeline embolization device(PED)in intracranial vertebral artery an-eurysms(IVAs)and their different forms.Methods A total of 135 patients(145 aneurysms)with intracranial IVAs who received PED treatment in Beijing Tiantan Hospital Affiliated to Capital Medical University from January 2015 to December 2020 were selected as the study objects.According to the morphology of aneurysms,the included patients were divided into the vertebral artery dissection aneu-rysm group(n = 61,64 vertebral artery dissection aneurysms)and the vertebral artery non-dissection aneurysm group(n =74,81 ver-tebral artery non-dissection aneurysms).Demographic information,aneurysm baseline information,surgical information and treatment outcome were compared between the two groups.Univariate and multivariate Logistic regression were used to analyze the independent risk factors for postoperative aneurysm adverse outcomes.Results There was no significant difference in demographic information be-tween the two groups(P＞0.05).The diameter of the parent artery and the length and diameter of PED used during surgery in the ver-tebral artery dissecting aneurysm group were higher than those in the non-dissecting aneurysm group,with statistical significance(P＜0.05).There was also statistical significance in the proportion of different aneurysm shapes between the two groups(P＜0.05).During the follow-up of PED treatment IVAs,the incidence of good outcome was 95.7%(134/140)and the incidence of bad outcome was 4.3%(6/140).The incidence of adverse outcome in vertebral artery dissecting aneurysm group was lower than that in non-dissecting aneurysm group,but the difference was not statistically significant(P＞0.05).There was no significant difference in the incidence of postoperative clinical complications between the two groups(P＞0.05).In terms of imaging outcomes,the total incidence of complete aneurysm occlusion in IVAs was 84.3%(102/121),the incidence of incomplete aneurysm occlusion was 15.7%(19/121),and the incidence of postoperative imaging complications with parent artery stenosis was21.5%(26/121).There was no significant difference in the incidence of incomplete aneurysm occlusion between the two groups(P＞0.05).However,the incidence of parent artery stenosis in the vertebral artery dissecting aneurysm group was significantly higher than that in the non-dissecting aneurysm group,with statistical significance(P＜0.05).Multivariate Logistic regression analysis showed that multiple aneurysms were an independent risk factor for poor prognosis after PED treatment of IVAs(P =0.021).Conclusion PED treatment of IVAs has good safety and efficacy,and there is no significant difference in efficacy between vertebral artery dissecting aneurysms and vertebral artery non-dissecting aneurysms,but the risk of associated complications is still noteworthy.
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