p64 flow diverter: Results in 108 patients from a single center.
Flow diversion
flow diverter
interventional radiology
intracranial aneurysm
Journal
Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences
ISSN: 2385-2011
Titre abrégé: Interv Neuroradiol
Pays: United States
ID NLM: 9602695
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
pubmed:
9
6
2020
medline:
25
11
2021
entrez:
9
6
2020
Statut:
ppublish
Résumé
Flow diverters are increasingly used to treat intracranial aneurysms. We report the safety and efficacy of the p64 flow diverter, a resheathable and detachable device for intracranial aneurysms. We retrospectively reviewed 108 patients with 109 aneurysms treated with the p64 between March 2014 and July 2019. There were 87 women and 21 men, mean age 57 years. Of 109 aneurysms, 74 were discovered incidentally, 12 were symptomatic, 18 were previously treated, and five were ruptured dissection aneurysms. A total of 10 aneurysms were located in the posterior circulation. The mean aneurysm or remnant size was 8.1 mm. Hemorrhage by perforation with the distal guidewire occurred in two patients with permanent neurological deficits in one. In one patient, acute in-stent occlusion caused infarction with a permanent deficit. Permanent morbidity was 1.9% (2 of 108, 95%CI 0.1-6.9%); there was no mortality. During follow-up, three in-stent occlusions occurred, all asymptomatic. There were no delayed hemorrhagic complications. At six months, 77 of 96 aneurysms (80.2%) were completely occluded, and at last follow-up, this increased to 93 of 96 aneurysms (96.9%). In-stent stenosis at any degree occurred in 11 patients, progressing to asymptomatic complete occlusion in one. In the other patients, stenosis resolved or improved at further follow-up. The p64 offers an effective and safe treatment option. Aneurysm occlusion rate was 97% at last follow-up, mostly achieved with a single device. There were no delayed hemorrhagic complications. Delayed in-stent stenosis infrequently progresses to occlusion but remains a matter of concern.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Flow diverters are increasingly used to treat intracranial aneurysms. We report the safety and efficacy of the p64 flow diverter, a resheathable and detachable device for intracranial aneurysms.
MATERIALS AND METHODS
METHODS
We retrospectively reviewed 108 patients with 109 aneurysms treated with the p64 between March 2014 and July 2019. There were 87 women and 21 men, mean age 57 years. Of 109 aneurysms, 74 were discovered incidentally, 12 were symptomatic, 18 were previously treated, and five were ruptured dissection aneurysms. A total of 10 aneurysms were located in the posterior circulation. The mean aneurysm or remnant size was 8.1 mm.
RESULTS
RESULTS
Hemorrhage by perforation with the distal guidewire occurred in two patients with permanent neurological deficits in one. In one patient, acute in-stent occlusion caused infarction with a permanent deficit. Permanent morbidity was 1.9% (2 of 108, 95%CI 0.1-6.9%); there was no mortality. During follow-up, three in-stent occlusions occurred, all asymptomatic. There were no delayed hemorrhagic complications. At six months, 77 of 96 aneurysms (80.2%) were completely occluded, and at last follow-up, this increased to 93 of 96 aneurysms (96.9%). In-stent stenosis at any degree occurred in 11 patients, progressing to asymptomatic complete occlusion in one. In the other patients, stenosis resolved or improved at further follow-up.
CONCLUSION
CONCLUSIONS
The p64 offers an effective and safe treatment option. Aneurysm occlusion rate was 97% at last follow-up, mostly achieved with a single device. There were no delayed hemorrhagic complications. Delayed in-stent stenosis infrequently progresses to occlusion but remains a matter of concern.
Identifiants
pubmed: 32506988
doi: 10.1177/1591019920932048
pmc: PMC7903539
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
51-59Références
J Neurointerv Surg. 2017 Jan;9(1):70-76
pubmed: 27439887
Clin Neuroradiol. 2018 Dec;28(4):563-568
pubmed: 28488025
Stroke. 2013 Feb;44(2):442-7
pubmed: 23321438
Stroke. 2001 Mar;32(3):597-605
pubmed: 11239174
AJNR Am J Neuroradiol. 2014 Apr;35(4):727-33
pubmed: 24072622
Radiology. 2014 Feb;270(2):394-9
pubmed: 24086073
AJNR Am J Neuroradiol. 2014 Dec;35(12):2326-33
pubmed: 24722307
J Clin Neurosci. 2014 Jul;21(7):1116-22
pubmed: 24524952
J Clin Neurosci. 2014 Feb;21(2):203-6
pubmed: 24128768
Clin Neuroradiol. 2015 Oct;25 Suppl 2:317-24
pubmed: 26031430
J Neurointerv Surg. 2016 Jan;8(1):94-8
pubmed: 25387731
J Neurointerv Surg. 2020 Sep;12(9):869-873
pubmed: 32005761
Clin Neurol Neurosurg. 2017 Oct;161:78-87
pubmed: 28863286
J Neurointerv Surg. 2019 Jun;11(6):610-613
pubmed: 30415222
J Neurosurg. 1992 Oct;77(4):515-24
pubmed: 1527608
Clin Neuroradiol. 2020 Sep;30(3):471-480
pubmed: 31399749
Radiology. 2013 Jun;267(3):858-68
pubmed: 23418004
J Neurointerv Surg. 2016 Feb;8(2):173-80
pubmed: 25895510
Stroke. 2013 Jun;44(6):1567-77
pubmed: 23686973
Neurosurgery. 2009 Apr;64(4):632-42; discussion 642-3; quiz N6
pubmed: 19349825
Neuroradiology. 2017 Mar;59(3):263-269
pubmed: 28236050
AJNR Am J Neuroradiol. 2012 Jun;33(6):1150-5
pubmed: 22300924
Stroke. 2011 Aug;42(8):2363-8
pubmed: 21737793
AJNR Am J Neuroradiol. 2019 Nov;40(11):1916-1923
pubmed: 31624118
AJNR Am J Neuroradiol. 2017 Mar;38(3):596-602
pubmed: 28104636
Lancet. 2005 Sep 3-9;366(9488):809-17
pubmed: 16139655
J Biomech Eng. 2014 Jun;136(6):061006
pubmed: 24718997
AJNR Am J Neuroradiol. 2015 Nov;36(11):2082-9
pubmed: 26272970
AJNR Am J Neuroradiol. 2016 Jan;37(1):19-24
pubmed: 26316566