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目的 探究Tubridge血流导向装置(tubridge embolization device, TED)和Pipeline血流导向装置(pipeline embolization device, PED)在老年复杂颅内动脉瘤的应用疗效及并发症。方法 选择2021年1月至2023年7月天水市中西医结合医院神经外科收治的老年复杂颅内动脉瘤患者119例，根据所用装置不同分为TED组71例和PED组48例。评价两组装置输送情况及并发症，术中、术后行数字减影血管造影(digital subtractive angiography, DSA)评价动脉瘤栓塞情况(Raymond分级),术前、术后3、6个月改良的Rankin量表(modified Rankin scale, mRS)评分评价临床症状和预后，术后6个月DSA评价治疗有效性，术后3、6和12个月分别行DSA和磁共振血管成像记录动脉瘤影像学随访情况。结果 TED组与PED组装置输送成功率及术中、术后并发症发生率比较，差异无统计学意义(P>0.05)。两组术中和术后Raymond分级比较，差异无统计学意义(P>0.05)。两组术前和术后3、6个月mRS评分比较，差异无统计学意义(P>0.05)。TED组与PED组术后6个月O'Kelly-Marotta分级和有效性比较，差异无统计学意义(P>0.05)。TED组术后3、6和12个月完全闭塞率分别为64.8%、63.8%和69.4%,PED组完全闭塞率分别为70.8%、71.7%和72.5%,两组动脉瘤完全闭塞率比较，差异无统计学意义(P>0.05)。结论 TED和PED在老年复杂颅内动脉瘤手术成功率、安全性、动脉瘤栓塞效果、即刻疗效、长期疗效及神经功能预后等方面效果相当，存在一定术中、术后并发症风险，临床可根据患者实际选择合适血流导向装置进行治疗。
Abstract：Objective To explore the application efficacy and complication occurrences of Tubridge embolization device(TED) and Pipeline embolization device(PED) in the treatment of elderly patients with complex intracranial aneurysm(ICA).Methods A total of 119 elderly patients with complex ICA admitted in our hospital from January 2021 to July 2023 were enrolled, and according to different devices they used, they were divided into a TED group(n=71) and a PED group(n=48).Device delivery and complications were observed, digital subtraction angiography(DSA) was performed intra-and post-operatively to evaluate the embolization of aneurysms(Raymond grading),and modified Rankin scale(mRS) was adopted to assess the clinical symptoms and prognosis before and at 3 and 6 months after surgery.DSA was applied again at 6 months post-operatively to evaluate the effectiveness of treatment.DSA and magnetic resonance angiography were carried out to record aneurysm images during the follow-up of 3,6 and 12 months after surgery.Results There were no statistical differences between the TED group and PED group in terms of the success rate of device delivery and the incidences of intraoperative and postoperative complications, of the intraoperative and postoperative Raymond grades, and of the mRS scores before surgery and at 3 and 6 months after surgery, and of the O-Kelly-Marotta grades and effectiveness at 6 months after surgery(P>0.05).At 3,6 and 12 months after surgery, the complete occlusion rate was 64.8%,63.8% and 69.4% respectively in the TED group, and 70.8%,71.7% and 72.5% respectively in the PED group, and there was no significant difference in the rate between the two groups(P>0.05).Conclusion TED and PED have similar efficiencies in the success rate of operation, safety, aneurysm embolization efficacy, immediate and long-term efficacies, and neurological function prognosis in the elderly patients with complex ICA.There exists a certain risk of intraoperative and postoperative complications.Clinically, appropriate blood flow guiding devices should be selected based on the patient's actual condition.
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基本信息:
中图分类号:R651.12
引用信息:
[1]郭伟,田建平,王晓宏.不同血流导向装置在老年复杂颅内动脉瘤的应用疗效及并发症观察[J].中华老年心脑血管病杂志,2025,27(09):1252-1256.
2025-09-15
2025-09-15