BACKGROUND AND PURPOSE:The development of flow diverters has changed the endovascular approach to intracranial aneurysms. On the basis of good results, the indications for flow diverters have expanded to include aneurysms of different shapes, locations, and sizes. The objective of the study was to report on the performance of the Flow Re-Direction Endoluminal Device (FRED) in intracranial aneurysm treatment at early and medium-term follow-up. MATERIALS AND METHODS:This single-arm, multicentric, prospective, observational study assessed aneurysm treatment with the FRED. The primary outcome was complete aneurysm occlusion at 6 and 12 months, and the secondary outcome was to evaluate the safety of the FRED with respect to stroke and death rates. RESULTS:Between June 2016 and August 2018, a total of 100 consecutive patients with 131 aneurysms were treated in 107 procedures. Total occlusion rates were 91% and 95% at 6 and 12 months. There was 1 death, and the total final morbidity rate was 1.8%. The complication rate was 4.6%.CONCLUSIONS: As reported previously, the FRED has proved to be a safe and effective tool, with high occlusion rates. The design of the stent makes it more difficult to perform balloon angioplasty compared with similar devices. A branch arising from the aneurysm sac was found to be a predictor of nonocclusion at 12 months, though larger series are needed to estimate the magnitude of the association.

SinopseAs complicações da ventriculoperitoniostomia são bem conhecidas, entre elas infecções, distúrbios relacionados à posição e localização do cateter, hematomas subdurais (HSD) e extradurais (HED), hemorragias intracerebrais e intraventriculares, além de pneumoencéfalo. Os HSD bilaterais decorrentes dessa técnica não são infreqüentes e normalmente evoluem cronicamente. Neste trabalho é apresentado um caso de hematoma subdural bilateral, seguido de hematoma extradural, como conseqüência de ventriculoperitoniostomia em paciente portador de hidrocefalia obstrutiva, decorrente de meningoencefalite bacteriana com encefalopatia infantil. É feita a revisão da literatura especializada, discutida a fisiopatologia e enfatizado o risco dessas complicações, principalmente nos pacientes que apresentam hidrocefalia com atrofia cerebral, que concluímos favorecer a formação dessas coleções hemorrágicas devido à redução volumétrica do encéfalo. Palavras-chaveHidrocefalia, derivação ventriculoperitoneal, complicação, hematoma subdural, hematoma extradural. Abstract Acute extradural hematoma after surgical treatment of a chronic subdural hematoma following ventriculoperitoneal shunt insertion -Report of a caseVentriculoperitoneal shunt complications are well recognized, such as infection, problems with the catheter's positioning and placement, subdural and epidural hematomas, intracerebral hemorrhage, intraventricular hemorrhage, and pneumocephalus. Bilateral subdural hematomas after this technique are not infrequent and usually have chronic evolution. This article presents a case of bilateral subdural hematoma followed postoperatively by epidural hematoma, after ventriculoperitoneal shunting in a patient with obstructive hydrocephalus caused by bacterial meningoencephalitis with infantile encephalopathy. The physiopathology and the risks of these complications, especially in patients who have hydrocephalus with cerebral atrophy, are discussed with: we suggest that the encephalon's volumetric reduction make these patients prone to these complications, and the surgeons should be aware of it.

No abstract

No abstract

No abstract