Neurovascular reconstruction with flow diverter stents for the treatment of 87 intracranial aneurysms: Clinical results

• Published in: Interventional neuroradiology Vol. 21; no. 3; pp. 292 - 299
• Main Authors: Giacomini, Leonardo, Piske, Ronie L, Baccin, Carlos E, Barroso, Marcelo, Joaquim, Andrei F, Tedeschi, Helder
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-06-2015
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Aneurysm; Angiography, Digital Subtraction; Cerebral Angiography; Embolization, Therapeutic - instrumentation; Female; Humans; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - therapy; Magnetic Resonance Angiography; Male; Middle Aged; Radiography, Interventional; Retrospective Studies; Stents; Treatment Outcome; flow diverter stent; endovascular; SILK; Aneurysm; Pipeline
• ISSN: 1591-0199; 2385-2011
• DOI: 10.1177/1591019915582153

Background
Flow diverter stents represent a new endovascular tool to treat complex aneurysms, such as giant, large, wide-necked and fusiform. The highly dense mash of these stents reduces inflow and outflow inside the aneurysm, resulting in intra aneurysmal thrombosis and stent endothelialization.
Objectives
To present the results of treatment of intracranial aneurysms with flow diverter stents in a single center.
Methods
Retrospective review of 77 patients with 87 aneurysms treated using two different types of flow diverter stent, the Pipeline Embolization Device and SILK stent, between October 2010 and September 2013 in an interventional neuroradiology center.
Results
Flow diverter stent placement was successful in 98% of the lesions and resulted in an immediate major stasis within most of the treated aneurysms. The overall aneurysm occlusion rate at six months and 18 months was 80% and 84% respectively. Symptomatic complications occurred in 11 patients (14.3%) with morbidity in eight (10.4%) and mortality in three patients (3.9%).
Conclusion
Flow diversion is a promising technique for treatment of challenging intracranial aneurysms with acceptable morbidity. A high rate of complete occlusion for small large necked aneurysms, a low morbidity and mortality rate and no recanalization encourage their use in these aneurysms. Further studies accessing long-term aneurysm occlusion and recanalization are required.