Flow-Diverter Stents for the Treatment of Saccular Middle Cerebral Artery Bifurcation Aneurysms

Abstract

BACKGROUND AND PURPOSE:The flow-diverter stent has been proved a feasible, safe, and efficient technique, particularly for the treatment of large and broad-neck carotid siphon aneurysms. Wide-neck bifurcation aneurysms remain, in some cases, a challenge for neurointerventionalists. We report the outcomes of the treatment of saccular middle cerebral artery bifurcation aneurysms with flow diversion in our institution.

Middle Cerebral Artery Bifurcation Aneurysms Treated by Extrasaccular Flow Diverters: Midterm Angiographic Evolution and Clinical Outcome

“…In this series, the rupture rate was 0% within the first year and beyond, similar to other recently published data. 4,12,13 In this cohort of MCA bifurcation aneurysms, the flow-diversion effect, even though angiographically slow and progressive, still protected the aneurysms from rupture throughout the follow-up period (Fig 3). Angiographic assessment should probably be performed systematically later than the usual one (ie, 6 months) performed for other endovascular techniques (Fig 4).…”

Endovascular Coiling of Wide-Neck and Wide-Neck Bifurcation Aneurysms: A Systematic Review and Meta-Analysis

“…15 However, it is important to note that flow-diverter treatment of bifurcation aneurysms can be challenging and is associated with higher morbidity rates and lower occlusion rates that those reported for aneurysms of the ICA. In a study of 14 patients with MCA bifurcation aneurysms treated with flow diverters, Caroff et al 16 found complete occlusion rates of 62%…”

Flow diversion of bifurcation aneurysms is more effective when the jailed branch is occluded: an experimental study in a novel canine model

“…In the setting of poor collateral circulation, jailing of the branch may lead to ischemic complications 13. However, in circumstances where robust collaterals exist, branch occlusion may promote aneurysm occlusion.…”