A Study on the Efficacy and Safety of Pipeline Shield Stents and Nonmodified Surface Flow-Diverting Stents in Patients with Intracranial Aneurysms.

BACKGROUND: Few studies have compared the Pipeline Shield stents with previous generations of flow-diverting stents (FDSs) for the treatment of unruptured intracranial aneurysms. This study aimed to evaluate the efficacy and safety of Pipeline Shield stents and FDSs without modified surfaces. METHODS: The present evaluation is a retrospective cohort study of patients endovascularly treated with Pipeline Shield stents or FDSs without modified surfaces for unruptured intracranial aneurysms between January 2014 and June 2022. The data analyzed were obtained from the anonymized database of our institution's interventional radiology service. RESULTS: A total of 147 patients with 155 unruptured intracranial aneurysms were included. Of the 155 aneurysms, 96 were treated with Pipeline Shield stents and 59 with FDSs without modified surfaces. The aneurysms treated with Pipeline Shield stents had higher 6-month (O'Kelly-Marotta [OKM] D; 87.5% vs. 71.4%; P = 0.025) and 1-year (OKM D; 82.5% vs. 63.0%; P = 0.047) occlusion rates than the aneurysms treated using FDSs without modified surfaces. No differences between the devices were found at the 1-year follow-up in the incidence of ischemic stroke (P = 0.939) or hemorrhagic complications (P = 0.559). CONCLUSIONS: Pipeline Shield stents demonstrated superior complete occlusion rates (OKM D) at both the 6-month and the 1-year follow-up assessments compared with nonmodified surface FDSs. No significant differences were found in the safety profiles between the 2 types of stents with regard to thromboembolic complications and ischemic events. Further research with larger study populations is necessary to validate these findings.

Angiographic outcomes of embolization in patients with intracranial aneurysms with coil- assisted Laser cut stent versus braided stents.

INTRODUCTION: Intracranial aneurysms (IA) are a focal dilatation of the vessel wall, the rupture of these, causes subarachnoid hemorrhage. Until now, endovascular management is the ideal treatment, providing the interventionist a range of options among which the stent and coils embolization stands out because of its occlusion rate. This study presents the results of a retrospective cohort comparing the effectiveness, morbidity, and mortality of IA treatment with laser-cut stent-assisted coils versus braided stents. METHODOLOGY: Retrospective cohort of patients diagnosed with unruptured intracranial aneurysms treated with coil-assisted laser-cut stents or braided stents between January 2014 and December 2021. RESULTS: In total, 138 patients with 147 intracranial aneurysms were analyzed, 91 of them were treated with laser-cut stent and 56 with braided stents. The main antecedent was arterial hypertension (48.55%). In the immediate angiographic control, a Raymond Roy scale (RRO) I was obtained in 86.81% of the patients with laser-cut stents and 87.50% of the patients with braided stents. In the angiographic follow-up at 12 months, an RRO I occlusion rate of 85.19% was reported in both groups. Perioperative complications occur in 16 patients treated with laser-cut stents and 12 patients treated with braided stents. Three patients presented bleeding complications during the 12-month follow-up, of which two correspond to patients treated with braided stents and one with a laser-cut stent. CONCLUSION: Treatment of patients with intracranial aneurysms with laser-cut stents or braided stents and coils is just as safe and effective.

Incidencia de endofugas en pacientes con aneurismas de aorta abdominal infrarrenal intervenidos con técnica endovascular / Incidence of endoleaks in patients with infrarenal abdominal aortic aneurysms treated on with the endovascular technique

Introducción: Las endofugas son la complicación más frecuente de los tratamientos endovasculares de aneurismas de aorta abdominal y torácica. El objetivo de este estudio es describir la frecuencia de endofugas en pacientes con aneurismas de aorta infrarrenal tratados con técnicas endovasculares. Metodología: Estudio de cohorte retrospectivo en el que se incluyeron pacientes con aneurismas infrarrenales tratados con terapia endovascular en dos instituciones de alta complejidad entre el 1 de septiembre de 2013 y el 1 de marzo de 2021. Se incluyeron datos demográficos, antecedentes, características morfológicas del cuello y saco del aneurisma, tipo de prótesis utilizada, presencia y tipo de endofuga. Se realizó un análisis descriptivo univariado. Los intervalos de confianza se describieron con un 95%. Resultados: Se incluyeron 99 pacientes, la media de edad fue 74,37 años, la media de la longitud del cuello fue de 29,47 mm, el 90,24% tuvieron una longitud favorable (>15mm). La media del ángulo fue de 44,57°, el 67,86% tenía un ángulo favorable (<60°). El 28,28% de los pacientes presentaron endofugas, la frecuencia de las endofugas tipo Ia fue de 7,07%, las de tipo Ib 8,08%, las de tipo II 18,37%, las de tipo IIIa y IIIb 1,01%. No se presentaron endofugas tipo IV ni V. Conclusiones: La frecuencia de presentación de endofugas fue del 28,28%; la endofuga más frecuente es la de tipo II 18,37%, ligeramente inferior a lo descrito en la literatura.

Introduction: Endoleaks are the most common complication of endovascular treatment of abdominal and thoracic aortic aneurysms.. The objective of this study is to describe the frequency of endoleaks in patients with infrarenal aortic aneurysms treated with endovascular techniques. Methodology: Retrospective cohort study that included patients from September 1, 2013, to March 1, 2021, with infrarenal aneurysms treated with endovascular therapy at the FOSCAL and FOSCAL international clinics. Demographic data, history, morphological characteristics of the aneurysm neck and sac, type of prosthesis used, presence, and type of endoleak were included. A univariate descriptive analysis was performed. Confidence intervals were reported at 95%. Results: 99 patients were included, the mean age was 74.37 years, the mean neck length was 29.47 mm, 90.24% had a favorable length (>15 mm); The mean angle was 44.57, 67.86% had a favorable angle (<60º). 28.28% of the patients presented endoleaks, the frequency of type Ia endoleaks was 7.07%, type Ib endoleaks 8.08%, type II 18.37%, type IIIa, and IIIb endoleaks 1, 01%. There were no type IV or type V endoleaks. Conclusions: The frequency of presentation of endoleaks was 28.28%; the most frequent endoleak is type II 18.37%. slightly lower than that reported in the literature