Flow diverter stent for treatment of cerebral aneurysms: A report of 130 patients with 134 aneurysms

Abstract

Background: This study aims to report our experience with cerebral aneurysms, which may improve in the treatment with the flow-diverter stent and follow up. Methods: This study was conducted in a consecutive series of 130 patients. 134 procedures were performed for treating these patients in Hanoi Medical University Hospital and Bach Mai Hospital from January 2012 to April 2017. 143 flow diverter stents (Pipeline, FRED and SILK) were used. Aneurysm morphology, stent patency and cerebral parenchyma before and after intervention were analyzed on images of digital subtraction angiography (DSA), computed tomography (CT) and magnetic resonance (MR). The follow-up data after 3-6 months and 12 months were recorded. Results: In 130 patients (31 men, 99 women), aneurysms of internal carotid artery were mostly common (92.6%), especially in cavernous (35.1%) and in para-ophthalmic (40.3%) segments. 83 cases (61.9%) had wide-neck aneurysms, and 16 cases (11.9%) had multiple aneurysms, and only 5 cases (3.7%) had blister-liked aneurysms. Endovascular treatment was successfully performed at rate of 94.8%. In 3 patients, the stent could not be delivered. Mortality and morbidity rates were 1.5% and 3.7%, respectively. MRI and MSCT follow-up at 3 months showed complete or incomplete occlusions of aneurysms was 7.4% or 17.5%, respectively. 3 patients experienced a thromboembolic event (4.3%). Conclusions: Intracranial aneurysms of cavernous and para-ophthalmic segments of internal carotid artery are mostly common with wide-neck and multi aneurysms. Deployment of flow diverter stent is safe and effective with high rate of successful and low procedural complications.

Flow diversion for compressive unruptured internal carotid artery aneurysms with neuro-ophthalmological symptoms: a systematic review and meta-analysis

“…Literature search was performed on March 21, 2022. After removal of duplicates and screening of titles and abstracts, we sought for the original articles of 82 publications 7 13–93. After completion of literature review and data extraction and before closing the database, the literature search was repeated on PubMed only on May 22, 2022, using the above-mentioned search string to identify additional potentially eligible articles.…”

A case report: Ruptured aneurysm with a wide neck treated by flow diverter stent and coil embolization

“…However, time for thrombosis in the aneurysm after putting FDS was longer as compared with coil techniques. In addition, before performing endovascular treatment by FDS, dual antiplatelet therapy should be used to prevent intraluminal stent thrombosis and stroke [ 22 , 23 ], which might increase risk of rebleeding in the case with ruptured aneurysm [22] . Therefore, in order to reduce the risk of recurrent bleeding for the ruptured aneurysm, the shorter the time for the use of DAPT before intervention should be considered.…”

Intracranial aneurysms in pediatric population treated with flow diverters: A single-center experience

“…Endovascular management has shown to be safe, effective, and long lasting for this type of aneurysms. [ 39 ] Treatment with FDs in children can be justified due to the great experience globally acquired in adult treatments,[ 6 , 7 , 11 , 22 , 27 ] as well as to the high incidence of giant and fusiform aneurysms on pediatric population, which makes them more susceptible for treatment with these devices. [ 4 ] The treatment with FDs in Mexico was just approved at 2015, and La Raza Medical Center was the first to place one at April, being this a FRED device.…”