Aims and objectives
With the development of endovascular devices,
intracranial stents and flow diverters have become major options for treating vertebral fusiform aneurysms.
Flow-diverter devices (FDDs) are new-generation stents placed in the parent artery at the level of the aneurysm neck to disrupt the intra-aneurysmal flow thus favoring intra-aneurysmal thrombosis.
This study reports our preliminary experience with the endovascular treatment of intracranial aneurysms using flow-diverter stents (FDs)
Methods and materials
From January 2015 to December 2017,
6 patients (3 men and 3 women; mean age 61,8 years) were treated with FDs.
Technical issues,
immediate findings,
delayed complications,
and imaging (computed tomography /magnetic resonance angiography,
digital subtraction angiography) follow-up were assessed.
A total of 14 FDs were placed,
3 Pipeline,
9 Leo and 2 Codeman stents.
Results
In five cases fusiform aneurysms were located in basilar artery,
while in one case in vertebral artery.
No complications during the procedure or in postoperative period were observed.
Vascular imaging follow-up (n=10,
range,
1-32 months) showed complete or near occlusion of an aneurysm in 4 patients,
there were no follow-ups for two patients.
There was one case of stent thrombosis 9 months after the procedure,
but no cases with acute thrombosis.
Progressive hydrocephalus and following ventriculoperitoneal shunting were observed in one case.
Another case with...
Conclusion
Because of the high rate of occlusion of the aneurysm sac and low incidence of intra- and postprocedural complications, we believe that the treatment with FDs could be a safe option in fusiform vertebrobasilar arterial system aneurysms.
Further studies are required regarding long-term safety,
efficacy,
and indications.
References
Tähtinen OI,
Manninen HI,
Vanninen RL,
et al.
The silk flow- diverting stent in the endovascular treatment of complex intracranial aneurysms: technical aspects and midterm results in 24 consecutive patients.
Neurosurgery 2012;70:617.
Byrne JV,
Beltechi R,
Yarnold JA,
Birks J,
Kamran M.
Early experience in the treatment of intra-cranial aneurysms by endovascular flow diversion: a multicentre prospective study.PLoS One 2010;5:e12492
Raphaeli G,
Collignon L,
De Witte O,
Lubicz B.
Endovascular treatment of posterior circulation fusiform aneurysms: single- center experience in 31 patients.
Neurosurgery 2011;69:274–83
LiuJ,JingL,ZhangY,SongY,WangY,LiC,etal....