Flow-Diverting Stents for Intracranial Bifurcation Aneurysm Treatment

Saleme, Suzana; Iosif, Christina; Ponomarjova, Sanita; Mendes, George A C; Camilleri, Yann; Caire, Fran çois; Boncœur, Marie-Paule; Mounayer, Charbel

doi:10.1227/neu.0000000000000522

Cited by 105 publications

(83 citation statements)

References 15 publications

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“…In addition, recently as also seen in our series, when used in the treatment of either bifurcation aneurysms or side wall aneurysms close to bifurcations, FDs are elongated covering the bifurcations and the branches. But when FDs are positioned including bifurcations, development of stenosis or occlusion on jailed branches are encountered more frequently than on parent arteries (14). Similarly, this is not present in the current outcome classification.…”

Section: Factors Affecting Angiographic Results On Follow-upmentioning

confidence: 87%

Silk device for the treatment of intracranial aneurysms, part 2: factors related to clinical and angiographic outcome

Kaya¹,

Dağlıoğlu²,

Gürkaş³

et al. 2015

Turkish Neurosurgery

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studies, experimental studies in the literature consist of studies where other adjunct devices other than flow diverters are not used and they do not represent the small narrownecked aneurysms frequently seen in routine daily practice. In these studies, flow diverter stents direct the blood flow along the parent artery (13) and provide stasis of the blood inside the aneurysm to promote thrombosis of the aneurysm █ INTRODUCTION Flow diverter (FD) devices have been the current endovascular treatment option for the hardly treated intracranial widenecked, fusiform and giant aneurysms (7). Recently, flow diverter stents have been the most important treatment modality because of acceptable morbidity, mortality and high aneurysm occlusion rates (5). Except for a few small AIM: To report patient and procedure-related factors affecting the angiographic and clinical outcome in patients treated with the Silk device. MATERIAL and METHODS:All patients with intracranial aneurysms in whom treatment was attempted with the Silk flow diverter by our neurovascular team between October 2010 and November 2013 were included consecutively. The data was analyzed by an independent stroke neurologist not involved in the treatment of the patients. RESULTS:A total of 96 patients (64 female) with ages range from 3 to 78 were included in this study. We found that 54 of the patients were asymptomatic and 42 of them symptomatic, while 21 had a prior history of subarachnoid hemorrhage (SAH). Mean aneurysm size was 10.2 mm (range 2 to 40 mm). 2 patients died due to consequences of SAH. 3 patients developed visual decline on the follow-up, 2 of these were procedure-related. Symptomatic thromboembolic events were noted in 7 cases. Patients with aneurysms smaller than 13 mm had significantly less complications and higher occlusion rates. The complication rate was significantly high in patients admitted with symptoms. Adjunctive coiling had no impact on outcome.CONCLUSION: Safety and efficacy of flow diversion in this series was closely related to aneurysm size and presenting symptoms. A size cut-off for safety and efficacy has not been reported before and will be useful not only for future studies but also for patient counseling in daily practice. The futility of adjunctive coiling in this series calls for reappraisal of the current recommendations for this specific device.

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Section: Factors Affecting Angiographic Results On Follow-upmentioning

confidence: 87%

Silk device for the treatment of intracranial aneurysms, part 2: factors related to clinical and angiographic outcome

Kaya¹,

Dağlıoğlu²,

Gürkaş³

et al. 2015

Turkish Neurosurgery

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“…The aneurysms treated with this technique were very challenging, and though anatomic results were superior in other FDS studies (80%-92%), [28][29][30] better results could be achieved with other techniques.…”

Section: 27mentioning

confidence: 73%

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

Caroff

Neki

Mihalea

et al. 2015

AJNR Am J Neuroradiol

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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.

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“…Therapeutic procedure details have been previously reported. 5,7 For uncomplicated cases, single FD coverage and slight oversizing of 0.25 or 0.5 mm in diameter were favored, except for large and giant aneurysms. Systematic oversizing was done to decrease mesh density across the aneurysm neck, to obtain a slower progressive aneurysm occlusion with less risk of abrupt occlusion of the vessel coming off the sac.…”

Section: Endovascular Technique and Procedure-related Medicationmentioning

confidence: 99%

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

Iosif

Mounayer

Yavuz

et al. 2016

AJNR Am J Neuroradiol

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Flow-Diverting Stents for Intracranial Bifurcation Aneurysm Treatment

Abstract: Symptomatic modifications of side branches after flow diverter treatment depend on the extent and type of collateral supply.

Cited by 105 publications

References 15 publications

Silk device for the treatment of intracranial aneurysms, part 2: factors related to clinical and angiographic outcome

Silk device for the treatment of intracranial aneurysms, part 2: factors related to clinical and angiographic outcome

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

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

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