İntrakraniyal anevrizmaların endovasküler tedavisinde woven endobridge (WEB) kullanımı: Retrospektif bir değerlendirme
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Dosyalar
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Woven EndoBridge (WEB) özellikle geniş boyunlu bifurkasyon anevrizmalarında kullanılan görece yeni bir tedavi modalitesidir. Çalışmamızın amacı hastanemizin WEB deneyimini sunmaktır. Yöntem: Eylül 2014 – Eylül 2017 tarihleri arasında intrakraniyal anevrizmaları hastanemizde WEB ile tedavi edilen 35 hasta çalışmaya dahil edilmiştir. Tedavi sonrası ortalama 10 ay (aralık: 1 – 33 ay) takip edilen edilen hastaların oklüzyon oranları MR anjiyografi ve dijital subtraksiyon anjiyografisi ile değerlendirilmiştir. Bulgular: Yirmi kadın, on beş erkek hastaya (ortalama yaş: 55; aralık: 32 – 76) ait 35 anevrizma (ortalama çap: 6,4 mm; aralık: 3,5 – 12 mm) WEB ile tedavi edilmiştir. Anevrizmaların 30'unda (%85) boyun ≥4 mm olarak bulunmuştur. Anevrizmaların 24'ü (%68) orta serebral arter bifurkasyonu, 5'i (%14) baziler tepe, 4'ü (%12) anterior komunikan, biri (%3) internal karotid arter tepe, biri de (%3) orta serebral arter M1 segmenti yerleşimli idi. Üç hastada rüptüre bağlı subaraknoid kanama vardı. Vakaların hepsinde cihaz başarılı bir şekilde yerleştirilebilmiştir. Takip incelemeleri olan 24 hastanın 23'ünde (%95) yeterli oklüzyon tespit edilmiştir. Bir hastada anevrizma kalıntısı saptanmış ve hasta akım çevirici stent ile tedavi edilmiştir. Hastalarda tedaviye bağlı morbidite ya da mortalite saptanmamıştır. Sonuç: Görece yeni bir modalite olduğu için uzun dönem takip verileri henüz mevcut olmamakla beraber WEB'in özellikle geniş boyunlu bifurkasyon anevrizmaları için orta vadeli takiplerde güvenli ve etkin bir tedavi modalitesi olduğu görülmektedir. Anahtar kelimeler: intrakraniyal anevrizma, endovasküler tedavi, woven endobridge
Woven EndoBridge is an innovative device for the treatment of intracranial aneurysms especially wide-necked bifurcation aneurysms. Here we present our experience with the WEB device. Methods: Thirty-five patients treated using the WEB device between September 2014 and September 2017 were included in the study. The patients were followed up for a mean of 10 months (range: 1 – 33 months) after the treatment and occlusion of the aneurysms were evaluated with MRA or DSA. Results: Thirty-five aneurysm of thirty-five patients (twenty female; fifteen male; mean age: 55; range: 32 – 76) were treated using the WEB device. The mean diameter of the aneurysms was 6,4 mm (range: 3,5 – 12 mm). The neck diameter was ≥4 mm in 85% of the aneurysms. The locations of the aneurysms were the middle cerebral artery bifurcation (%68), basilar tip (14%), anterior communicating artery (12%), internal carotid artery tip (3%), and M1 segment of the middle cerebral artery (3%). Three patients had subarachnoid hemorrhage due to aneurysm rupture. The device could be successfully deployed in all of the cases. Among the twenty-four patients who had follow up imaging by MRA or DSA, adequate occlusion was observed in twenty-three (95%). One patient who had aneurysm remnant on follow up imaging was treated with a flow diverter. There was no treatment related morbidity or mortality. Conclusion: Although long term follow-up data are not available due to its recent introduction, WEB intrasaccular flow disruptor seems to be effective and safe for intracranial wide necked, bifurcation aneurysm treatment in the midterm follow up. Keywords: intracranial aneurysm, endvascular treatment, woven endobridge
Woven EndoBridge is an innovative device for the treatment of intracranial aneurysms especially wide-necked bifurcation aneurysms. Here we present our experience with the WEB device. Methods: Thirty-five patients treated using the WEB device between September 2014 and September 2017 were included in the study. The patients were followed up for a mean of 10 months (range: 1 – 33 months) after the treatment and occlusion of the aneurysms were evaluated with MRA or DSA. Results: Thirty-five aneurysm of thirty-five patients (twenty female; fifteen male; mean age: 55; range: 32 – 76) were treated using the WEB device. The mean diameter of the aneurysms was 6,4 mm (range: 3,5 – 12 mm). The neck diameter was ≥4 mm in 85% of the aneurysms. The locations of the aneurysms were the middle cerebral artery bifurcation (%68), basilar tip (14%), anterior communicating artery (12%), internal carotid artery tip (3%), and M1 segment of the middle cerebral artery (3%). Three patients had subarachnoid hemorrhage due to aneurysm rupture. The device could be successfully deployed in all of the cases. Among the twenty-four patients who had follow up imaging by MRA or DSA, adequate occlusion was observed in twenty-three (95%). One patient who had aneurysm remnant on follow up imaging was treated with a flow diverter. There was no treatment related morbidity or mortality. Conclusion: Although long term follow-up data are not available due to its recent introduction, WEB intrasaccular flow disruptor seems to be effective and safe for intracranial wide necked, bifurcation aneurysm treatment in the midterm follow up. Keywords: intracranial aneurysm, endvascular treatment, woven endobridge
Açıklama
Anahtar Kelimeler
Anevrizma, Aneurysm, Endovasküler tedavi, Endovascular treatment, Protezler ve implantlar, Prostheses and implants, Retrospektif çalışmalar, Retrospective studies
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Künye
Kaya, H. E. (2018). İntrakraniyal anevrizmaların endovasküler tedavisinde woven endobridge (WEB) kullanımı: Retrospektif bir değerlendirme. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Radyoloji Anabilim Dalı, Konya.
