The p64 flow-diverting stent in the treatment of difficult cerebral vascular aneurysms: technical features and results

Abstract

Introduction. Since the appearance of the first flow-diverting stents (FDS) Pipeline (Covidien, USA) and Silk (Balt Extrusion, France) in 2008, numerous studies have been conducted that have shown their high efficiency in the treatment of difficult aneurysms, accompanied by a low frequency long-term recanalization with a moderate risk of developing intra- and postoperative complications, thus making them an alternative to the classic use of coils.The study objective is to evaluate the results of the p64 PPS using in the treatment of patients with cerebral aneurysms of various localization in a single neurosurgical hospital.Materials and methods. In the department of vascular neurosurgery of the Federal Neurosurgical Center, Novosibirsk for the period from June 2017 to December 2019, 90 patients (10 (11.1 %) male, 80 (88.9 %) female) with cerebral aneurysms were operated using p64 FDS.Results. All 90 patients received 93 p64 FDS. In 79 (87.8 %) patients, only a stent was implanted, in 9 (12.2 %) – in combination with coils. Follow-up after 6 months was observed in 39 (43.3 %) patients, while it should be noted that no patient showed an increase in neurological deficit. The complete occlusion rate after 6 months was 76.9 %. A favorable treatment outcome according to the modified Rankin Scale at the time of discharge was obtained in 82 (91.1 %) patients. Mortality was in 1 (1.1 %) case.Conclusion. The p64 FDS is an effective endovascular device in the treatment of patients with difficult cerebral aneurysms and has a rather low incidence of intra- and postoperative complications.