Flow Diverters Devices for Treatment of Intra-cranial Aneurysms – six Months Follow-up Results

Detalhes bibliográficos
Autor(a) principal: Baptista, Tiago
Data de Publicação: 2012
Outros Autores: Fragata, Isabel, Ribeiro, Clara, Reis, João
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/254
Resumo: Endoluminal reconstruction with flow diverter devices represents an innovative technique in the treatment of intracranial aneurysms. These new stents, self-expandable and of low porosity, are released through the microcatherization of the parent artery. The main goal of these systems is thereby rebuilding the vessel wall and excluding the aneurysmal formation of the arterial circulation. We show the preliminary results in treating 10 patients at Hospital de São José, Lisbon. These patients, with wide-necked (> 4 mm) or unfavorable dome/neck ratios (> 1.5) aneurysms, were treated with the PIPELINE® system, and angiographic control were made at three and six months. New control will be done at 12 months. The mean age of enrolled patients is 54.3 years; eight patients were female and two male. Aneurysms were incidentally discovered in two patients. The remaining patientes were diagnosed during imaging investigation for headache (n = 3), visual field defect (n = 1), vertigo (n = 1) and at least one cranial palsy (n = 2). Only two patients had had prior subarachnoid hemorrhage and two patients underwent prior endovascular treatment with coils. The locations of aneurysms treated were the proximal segment of the middle cerebral artery (n = 1) and the paraophthalmic (n = 6), ophthalmic (n = 2) and cavernous (n = 4) internal carotid artery segments. Thirteen intracranial aneurysms were treated as three patients had multiple aneurysms. Control studies were conducted and shown an average degree of occlusion at three months of 74% and at six months of 86%. There was no reduction in size of one paraophthalmic artery aneurysm. The experience of this department is favorable to the use of flow-diverter devices to treat selected aneurysms. High occlusion rates were obtained given the existing challenges in the treatment of such aneurysms.
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spelling Flow Diverters Devices for Treatment of Intra-cranial Aneurysms – six Months Follow-up ResultsSistemas de Derivação de Fluxo no Tratamento de Aneurismas Intra-cranianos – resultados aos seis Meses de SeguimentoEndoluminal reconstruction with flow diverter devices represents an innovative technique in the treatment of intracranial aneurysms. These new stents, self-expandable and of low porosity, are released through the microcatherization of the parent artery. The main goal of these systems is thereby rebuilding the vessel wall and excluding the aneurysmal formation of the arterial circulation. We show the preliminary results in treating 10 patients at Hospital de São José, Lisbon. These patients, with wide-necked (> 4 mm) or unfavorable dome/neck ratios (> 1.5) aneurysms, were treated with the PIPELINE® system, and angiographic control were made at three and six months. New control will be done at 12 months. The mean age of enrolled patients is 54.3 years; eight patients were female and two male. Aneurysms were incidentally discovered in two patients. The remaining patientes were diagnosed during imaging investigation for headache (n = 3), visual field defect (n = 1), vertigo (n = 1) and at least one cranial palsy (n = 2). Only two patients had had prior subarachnoid hemorrhage and two patients underwent prior endovascular treatment with coils. The locations of aneurysms treated were the proximal segment of the middle cerebral artery (n = 1) and the paraophthalmic (n = 6), ophthalmic (n = 2) and cavernous (n = 4) internal carotid artery segments. Thirteen intracranial aneurysms were treated as three patients had multiple aneurysms. Control studies were conducted and shown an average degree of occlusion at three months of 74% and at six months of 86%. There was no reduction in size of one paraophthalmic artery aneurysm. The experience of this department is favorable to the use of flow-diverter devices to treat selected aneurysms. High occlusion rates were obtained given the existing challenges in the treatment of such aneurysms.A reconstrução endoluminal com sistemas de derivação de fluxo (flow diverter devices) constitui uma técnica inovadora no tratamento de aneurismas intra-cranianos. Estes novos stents, auto-expansíveis e de reduzida porosidade, são libertados através de microcateterização da artéria portadora do aneurisma, reconstruindo assim a sua parede e excluindo a formação aneurismática da circulação arterial. Neste trabalho mostramos os resultados preliminares obtidos no tratamento de 10 doentes no Hospital de São José, Lisboa. Estes doentes, com aneurismas de colo largo (> 4mm) ou ratio saco/colo não favorável (< 1,5), foram tratados com o sistema PIPELINE®, e estudos angiográficos de controlo foram efectuados aos três e seis meses. Novo controlo será feito aos 12 meses. A idade media dos doentes envolvidos é de 54,3 anos, oito doentes são do sexo feminino e dois doentes do sexo masculino. Os aneurismas foram incidentalmente descobertos em dois doentes e os restantes foram diagnosticados no contexto de investigação imagiológica por cefaleias (n = 3), defeito de campo visual (n = 1), vertigens (n = 1) e parésia de pelo menos um par craniano (n = 2). Em apenas dois doentes foi observada hemorragia subaracnoideia e outros dois doentes foram submetidos a terapêutica endovascular prévia, com espiras metálicas. As localizações dos aneurismas tratados são o segmento M1/M2 da artéria cerebral média (n = 1) e os segmentos da artéria carótida interna para-oftálmico (n = 6), oftálmico (n = 2) e cavernoso (n = 4). Treze aneurismas intra-cranianos foram tratados uma vez que três doentes apresentavam múltiplos aneurismas. Os estudos de controlo efectuados demonstram um grau de oclusão médio aos três meses de 74% e aos seis meses de 86%. Não se observou qualquer redução das dimensões do saco de um dos aneurismas para-oftálmico. A experiência deste serviço é muito favorável a utilização de sistemas de derivação de fluxo no tratamento de aneurismas seleccionados, tendo obtido taxas de oclusão elevadas dados os desafios existentes na terapêutica deste tipo de aneurismas.Ordem dos Médicos2012-11-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/254oai:ojs.www.actamedicaportuguesa.com:article/254Acta Médica Portuguesa; Vol. 25 (2012): Supplement 1; 13-16Acta Médica Portuguesa; Vol. 25 (2012): Suplemento 1; 13-161646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/254https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/254/63Baptista, TiagoFragata, IsabelRibeiro, ClaraReis, Joãoinfo:eu-repo/semantics/openAccess2022-12-20T10:55:53Zoai:ojs.www.actamedicaportuguesa.com:article/254Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:23.854790Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Flow Diverters Devices for Treatment of Intra-cranial Aneurysms – six Months Follow-up Results
Sistemas de Derivação de Fluxo no Tratamento de Aneurismas Intra-cranianos – resultados aos seis Meses de Seguimento
title Flow Diverters Devices for Treatment of Intra-cranial Aneurysms – six Months Follow-up Results
spellingShingle Flow Diverters Devices for Treatment of Intra-cranial Aneurysms – six Months Follow-up Results
Baptista, Tiago
title_short Flow Diverters Devices for Treatment of Intra-cranial Aneurysms – six Months Follow-up Results
title_full Flow Diverters Devices for Treatment of Intra-cranial Aneurysms – six Months Follow-up Results
title_fullStr Flow Diverters Devices for Treatment of Intra-cranial Aneurysms – six Months Follow-up Results
title_full_unstemmed Flow Diverters Devices for Treatment of Intra-cranial Aneurysms – six Months Follow-up Results
title_sort Flow Diverters Devices for Treatment of Intra-cranial Aneurysms – six Months Follow-up Results
author Baptista, Tiago
author_facet Baptista, Tiago
Fragata, Isabel
Ribeiro, Clara
Reis, João
author_role author
author2 Fragata, Isabel
Ribeiro, Clara
Reis, João
author2_role author
author
author
dc.contributor.author.fl_str_mv Baptista, Tiago
Fragata, Isabel
Ribeiro, Clara
Reis, João
description Endoluminal reconstruction with flow diverter devices represents an innovative technique in the treatment of intracranial aneurysms. These new stents, self-expandable and of low porosity, are released through the microcatherization of the parent artery. The main goal of these systems is thereby rebuilding the vessel wall and excluding the aneurysmal formation of the arterial circulation. We show the preliminary results in treating 10 patients at Hospital de São José, Lisbon. These patients, with wide-necked (> 4 mm) or unfavorable dome/neck ratios (> 1.5) aneurysms, were treated with the PIPELINE® system, and angiographic control were made at three and six months. New control will be done at 12 months. The mean age of enrolled patients is 54.3 years; eight patients were female and two male. Aneurysms were incidentally discovered in two patients. The remaining patientes were diagnosed during imaging investigation for headache (n = 3), visual field defect (n = 1), vertigo (n = 1) and at least one cranial palsy (n = 2). Only two patients had had prior subarachnoid hemorrhage and two patients underwent prior endovascular treatment with coils. The locations of aneurysms treated were the proximal segment of the middle cerebral artery (n = 1) and the paraophthalmic (n = 6), ophthalmic (n = 2) and cavernous (n = 4) internal carotid artery segments. Thirteen intracranial aneurysms were treated as three patients had multiple aneurysms. Control studies were conducted and shown an average degree of occlusion at three months of 74% and at six months of 86%. There was no reduction in size of one paraophthalmic artery aneurysm. The experience of this department is favorable to the use of flow-diverter devices to treat selected aneurysms. High occlusion rates were obtained given the existing challenges in the treatment of such aneurysms.
publishDate 2012
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Acta Médica Portuguesa; Vol. 25 (2012): Suplemento 1; 13-16
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