[Efficacy of Pipeline embolization device in the treatment of large and giant intracranial aneurysms].

Objective: To summarize the safety and efficacy of Pipeline embolization device in the treatment of large and giant intracranial aneurysms (maximum diameter ≥ 10 mm). Methods: The clinical and imaging data of 22 patients with intracranial aneurysms treated by Pipeline Embolization Device (PED) from February 2015 to July 2016 in the Zhengzhou University People's Hospital were retrospectively analyzed. The results about postoperative clinical and imaging follow-up and complications were evaluated. Results: The PED were successfully implanted in 22 patients with 22 intracranial aneurysms. Two aneurysms were treated with PED alone, and 20 aneurysms were treated with PED assisted coil embolization. Perioperative complications occurred in 3 patients (13.6%), and 1 patient died because aneurysm ruptured 3 days after operation. Nineteen patients (19 aneurysms) obtain imaging follow-up visit 3-17 months after operation, 13 of the 19 aneurysms (68.4%) received complete and subtotal occlusion, with no aneurysm recurrence. Eighteen patients obtain clinical follow-up visit 16-32 months after operation, with mRS (modified Rankin scale) score 1 in 5 patients, mRS score 0 in 13 patients, none developed new neurologic symptoms. Conclusions: PED has showed the high rate of obliteration for the treatment of large and giant intracranial aneurysms. But the complications needs to be further studied.目的： 探讨Pipeline血流导向装置治疗颅内大动脉瘤(最大径≥10 mm)的安全性和治疗效果。 方法： 回顾性分析郑州大学人民医院2015年2月至2016年7月接受Pipeline血流导向装置治疗的22例颅内大动脉瘤患者的临床及影像资料，评估术后临床及影像随访结果及并发症发生情况。 结果： 22例共22枚大动脉瘤，手术均获成功，其中2例为单纯Pipeline血流导向装置置入，20例为Pipeline血流导向装置结合弹簧圈填塞治疗。3例(13.6%)发生围手术期并发症，其中1例(4.5%)术后3 d动脉瘤破裂死亡。19例(19枚动脉瘤)获影像学随访(3～17个月)，其中13枚(68.4%)动脉瘤获次全以上闭塞，无动脉瘤复发。18例患者获临床随访(16～32个月)，其中改良Rankin评分1分者5例，mRS评分0分者13例，均无出血或缺血事件发生。 结论： Pipeline血流导向装置治疗颅内大动脉瘤治愈率高。但如何更好的预防并发症仍需进一步研究。.