The p64 Flow Diverter-Mid-term and Long-term Results from a Single Center.


Journal

Clinical neuroradiology
ISSN: 1869-1447
Titre abrégé: Clin Neuroradiol
Pays: Germany
ID NLM: 101526693

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 25 04 2019
accepted: 19 07 2019
pubmed: 11 8 2019
medline: 8 6 2021
entrez: 11 8 2019
Statut: ppublish

Résumé

The p64 is a flow modulation device designed to be used in endovascular treatment of intracranial aneurysms. There is limited data on the long-term effectiveness of the device. This study sought to determine the safety and long-term efficacy of this device. A retrospective review of a prospectively maintained database was performed to identify all patients treated with a p64 between March 2015 and November 2018 at University Hospital St. Ivan Rilski. Anatomical features, intraprocedural complications, clinical, and angiographic outcomes were also taken into account and reviewed. A total of 72 patients with 72 aneurysms who met the inclusion criteria were identified. Device placement was successful in all patients. Follow-up angiographic imaging at 6 months showed complete occlusion (O'Kelly-Marotta scale [OKM] D) in 55 (76.3%) patients, subtotal aneurysmal filling (OKM B) in 10 (13.8%) patients, and neck remnant (OKM C) in 7 (9.7%) patients. Catheter angiography at 12 months was available for 70 patients (97.2%) and of these patients 91.4% of the aneurysms were completely occluded (OKM D) (64/72). Delayed angiography at 24 months was available for 68 patients (94.4%) and of these 98.5% (67/68) had completely occluded aneurysms. A 36-month angiography was available for 61 patients (84.4%) by which point all aneurysms had been completely occluded (100%). Permanent morbidity due to delayed aneurysmal rupture occurred in one patient (1.38%). The mortality rate was 0%. Self-limiting mild intimal hyperplasia was seen in 2 patients (2.72%). Treatment of intracranial aneurysms with a p64 flow modulation device is safe and effective with a high success rate and only infrequent complications.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
The p64 is a flow modulation device designed to be used in endovascular treatment of intracranial aneurysms. There is limited data on the long-term effectiveness of the device. This study sought to determine the safety and long-term efficacy of this device.
METHODS METHODS
A retrospective review of a prospectively maintained database was performed to identify all patients treated with a p64 between March 2015 and November 2018 at University Hospital St. Ivan Rilski. Anatomical features, intraprocedural complications, clinical, and angiographic outcomes were also taken into account and reviewed.
RESULTS RESULTS
A total of 72 patients with 72 aneurysms who met the inclusion criteria were identified. Device placement was successful in all patients. Follow-up angiographic imaging at 6 months showed complete occlusion (O'Kelly-Marotta scale [OKM] D) in 55 (76.3%) patients, subtotal aneurysmal filling (OKM B) in 10 (13.8%) patients, and neck remnant (OKM C) in 7 (9.7%) patients. Catheter angiography at 12 months was available for 70 patients (97.2%) and of these patients 91.4% of the aneurysms were completely occluded (OKM D) (64/72). Delayed angiography at 24 months was available for 68 patients (94.4%) and of these 98.5% (67/68) had completely occluded aneurysms. A 36-month angiography was available for 61 patients (84.4%) by which point all aneurysms had been completely occluded (100%). Permanent morbidity due to delayed aneurysmal rupture occurred in one patient (1.38%). The mortality rate was 0%. Self-limiting mild intimal hyperplasia was seen in 2 patients (2.72%).
CONCLUSION CONCLUSIONS
Treatment of intracranial aneurysms with a p64 flow modulation device is safe and effective with a high success rate and only infrequent complications.

Identifiants

pubmed: 31399749
doi: 10.1007/s00062-019-00823-y
pii: 10.1007/s00062-019-00823-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

471-480

Auteurs

S Sirakov (S)

Radiology department, University Hospital St. Ivan Rilski, Sofia, Bulgaria. ssirakov@bsunivers.com.

A Sirakov (A)

Radiology department, University Hospital St. Ivan Rilski, Sofia, Bulgaria.

P Bhogal (P)

Department of Interventional Neuroradiology, The Royal London Hospital, London, UK.

M Penkov (M)

Radiology department, University Hospital St. Ivan Rilski, Sofia, Bulgaria.

K Minkin (K)

Neurosurgery department, University Hospital St. Ivan Rilski, Sofia, Bulgaria.

K Ninov (K)

Neurosurgery department, University Hospital St. Ivan Rilski, Sofia, Bulgaria.

H Hristov (H)

Neurosurgery department, University Hospital St. Ivan Rilski, Sofia, Bulgaria.

V Karakostov (V)

Neurosurgery department, University Hospital St. Ivan Rilski, Sofia, Bulgaria.

R Raychev (R)

Department of Neurology and Comprehensive Stroke Center, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.

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Classifications MeSH