Patency of the Anterior Choroidal Artery after Flow-Diversion Treatment of Internal Carotid Artery Aneurysms

Brinjikji, Waleed; Kallmes, David F.; Cloft, Harry J.; Lanzino, Giuseppe

doi:10.3174/ajnr.a4139

Cited by 48 publications

(30 citation statements)

References 22 publications

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“…7,83 Our study has several merits compared with the previously published articles. First, because our study includes all available studies in this important field, it presents a complete overview of all available evidence on the adverse events in FDD strategies.…”

Section: Discussionmentioning

confidence: 70%

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Complications associated with the use of flow-diverting devices for cerebral aneurysms: a systematic review and meta-analysis

Zhou

Yin

et al. 2017

Neurosurgical Focus

141

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OBJECTIVEThe objective of this study was to review the literature on the use of flow-diverting devices (FDDs) to treat intracranial aneurysms (IAs) and to investigate the safety and complications related to FDD treatment for IAs by performing a meta-analysis of published studies.METHODSA systematic electronic database search was conducted using the Springer, EBSCO, PubMed, Medline, and Cochrane databases on all accessible articles published up to January 2016, with no restriction on the publication year. Abstracts, full-text manuscripts, and the reference lists of retrieved articles were analyzed. Random-effects meta-analysis was used to pool the complication rates across studies.RESULTSSixty studies were included, which involved retrospectively collected data on 3125 patients. The use of FDDs was associated with an overall complication rate of 17.0% (95% confidence interval [CI] 13.6%–20.5%) and a low mortality rate of 2.8% (95% CI 1.2%–4.4%). The neurological morbidity rate was 4.5% (95% CI 3.2%–5.8%). No significant difference in the complication or mortality rate was observed between 2 commonly used devices (the Pipeline embolization device and the Silk flow-diverter device). A significantly higher overall complication rate was found in the case of ruptured IAs than in unruptured IA (odds ratio 2.3, 95% CI 1.2–4.3).CONCLUSIONSThe use of FDDs in the treatment of IAs yielded satisfactory results with regard to complications and the mortality rate. The risk of complications should be considered when deciding on treatment with FDDs. Further studies on the mechanism underlying the occurrence of adverse events are required.

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Section: Discussionmentioning

confidence: 70%

“…44 Currently, parent vessel reconstruction with FDDs is rapidly becoming the preferred endovascular modality for giant and complex IAs. 7 In some areas, FDD application has drastically decreased the rate of coil and stent usage. …”

mentioning

confidence: 99%

Complications associated with the use of flow-diverting devices for cerebral aneurysms: a systematic review and meta-analysis

Zhou

Yin

et al. 2017

Neurosurgical Focus

141

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“…4,21 On the other hand, smaller vessels such as the anterior choroidal and lenticulostriate arteries and perforating vessels with no distal collaterals may maintain flow due to a pressure gradient across the ostium and are more likely to remain patent. 3,18,21 The higher rate of ophthalmic artery patency after flow diversion can probably be attributed to a higher continued physiological demand with the ophthalmic than the PCoA. 6 Furthermore, because both systems have an adequate collateral circulation, clinical symptoms do not usually develop in occluded arteries and in arteries with diminished flow.…”

Section: Discussionmentioning

confidence: 98%

Patency of the posterior communicating artery following treatment with the Pipeline Embolization Device

Daou

Valle-Giler

Chalouhi

et al. 2017

JNS

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OBJECTIVE The Pipeline Embolization Device (PED) has become an effective treatment strategy for some cerebral aneurysms. Concerns regarding the patency of branch arteries have been raised. The objective of this study was to assess the patency of the posterior communicating artery (PCoA) following treatment of PCoA aneurysms using the PED. METHODS All patients with PCoA aneurysms treated with the PED who had angiographic follow-up were retrospectively identified. The patency of the PCoA at follow-up was evaluated by 2 authors who were not involved in the intervention. Univariate and multivariate analyses were performed to identify factors associated with the following: 1) PCoA patency versus no or diminished flow, and 2) PCoA patency and diminished flow versus PCoA occlusion. RESULTS Thirty patients with an angiographic follow-up of 6 months were included. Aneurysm obliteration was achieved in 25 patients (83.3%). The PCoA was patent in 7 patients (23.3%), had diminished flow in 7 patients (23.3%), and was occluded in 16 patients (53.3%). In the univariate analysis of outcome, there was a trend for aneurysms with incomplete occlusion, aneurysms not previously treated, those with presence of a fetal PCoA, and those with an artery coming from the aneurysm to have higher odds of the PCoA remaining patent. In univariate and multivariate analyses of factors associated with outcome, fetal PCoA and presence of an artery coming from the aneurysm were associated with the PCoA remaining open with or without diminished flow. No patients had symptoms related to PCoA occlusion. CONCLUSIONS Occlusion and diminished flow through the PCoA is common following PED treatment of PCoA aneurysms. However, it is clinically insignificant in most cases.

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“…10 Finally, 2 reports with a combined total of 43 anterior choroidal arteries spanned by at least 1 FDS in the treatment of carotid aneurysms documented 2 branch occlusions (4.7%) at follow-up, without clinical sequelae. 11,12 No study found a significant association between branch occlusion and the number of FDS devices placed across vessel ostia.…”

Section: Discussionmentioning

confidence: 99%

Posterior Inferior Cerebellar Artery Patency after Flow-Diverting Stent Treatment

Levitt

Park

Albuquerque

et al. 2015

AJNR Am J Neuroradiol

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Patency of the Anterior Choroidal Artery after Flow-Diversion Treatment of Internal Carotid Artery Aneurysms

Cited by 48 publications

References 22 publications

Complications associated with the use of flow-diverting devices for cerebral aneurysms: a systematic review and meta-analysis

Complications associated with the use of flow-diverting devices for cerebral aneurysms: a systematic review and meta-analysis

Patency of the posterior communicating artery following treatment with the Pipeline Embolization Device

Posterior Inferior Cerebellar Artery Patency after Flow-Diverting Stent Treatment

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