Intracranial Aneurysms and Subarachnoid Haemorrhage

Harrigan, Mark R.; Deveikis, John P.

doi:10.1007/978-1-61779-946-4_13

Cited by 2 publications

(1 citation statement)

References 718 publications

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“…However, with more data available which supports the efficacy and safety of flow diverters for treatment of smaller (<7 mm) aneurysms, [21][22][23] the device is now being used more often in patients with small and less complex aneurysms. Given that the average size of a ruptured aneurysm was determined to lie between 6 mm and 7 mm, 24 it is important to consider treatment in patients with aneurysms approaching this size. In our patient population, the mean aneurysm size was 6.0 mm (maximum diameter).…”

Section: Discussionmentioning

confidence: 99%

Flow diverter for endovascular treatment of intracranial mirror segment internal carotid artery aneurysms

Kühn¹,

Kan

Srinivasan

et al. 2018

Interv Neuroradiol

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Background To evaluate the feasibility and efficacy of the pipeline embolization device in the treatment of unruptured intracranial mirror segment aneurysms. Methods Out of a total of 338 subjects, 14 were identified harboring a total of 32 internal carotid artery mirror segment aneurysms that were treated with the pipeline embolization device and were consecutively enrolled into our study. We collected data on patient demographics, modified Rankin scale (mRS) at admission, aneurysm characteristics, clinical outcome at discharge, 3–9 and at 12–18 months as well as angiography results at follow-up. Results Patients’ mean age was 52.9 years; baseline mRS was 0 in all subjects. Pipeline embolization device placement was successful in all cases. Post-treatment mRS remained 0 in 13/14 patients. One patient experienced a small intraparenchymal hemorrhage and subarachnoid hemorrhage, associated with a frontoparietal infarction resulting in right upper extremity weakness and aphasia (post-treatment mRS 3). His mRS evaluation remained stable at the 3–9-month follow-up. Three to 9-month follow-up angiography (13/14 subjects) showed complete aneurysm occlusion in 24/30 aneurysms (80%), near complete and partial occlusion in three of 30 (10%) aneurysms each. At the 9-month follow-up, one patient experienced a complete occlusion of the anterior temporal artery branch but did not present with any clinical deficits. No mRS changes were encountered over a median 6-month follow-up period. Mid-term follow-up angiography (12–18 months) available in eight of 14 subjects showed complete aneurysm occlusion in all patients. Mild intimal hyperplasia was observed in one patient. Conclusions Flow diversion technology can be used for the treatment of unruptured mirror segment aneurysms in selected patients.

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