Document Detail

Endovascular treatment of intracranial aneurysms in the flow diverter era: frequency of use and results in a consecutive series of 550 treatments in a single centre.
MedLine Citation:
PMID:  25207905     Owner:  NLM     Status:  In-Data-Review    
Flow diverter devices became available in our department in 2009. We considered treatment with flow diverters only in patients with aneurysms not suitable for surgery or conventional endovascular techniques. This paper presents our preliminary experience with flow diverters in a consecutive series of 550 endovascular aneurysm treatments. Between January 2009 and July 2013, 550 endovascular treatments for intracranial aneurysms were performed. Of these, 490 were first-time aneurysm treatments in 464 patients and 61 were additional treatments of previously coiled aneurysms in 51 patients. Endovascular treatments consisted of selective coiling in 445 (80.8%), stent-assisted coiling in 68 (12.4%), balloon-assisted coiling in 13 (2.4%), parent vessel occlusion in 12 (2.2%) and flow diverter treatment in 12 (2.2%). Eleven patients with 12 aneurysms were treated with flow diverters. Two patients had ruptured dissecting aneurysms. One patient with a basilar trunk aneurysm died of acute in stent thrombosis and another patient died of brain stem ischaemia at 32 months follow-up. One patient had ischaemia with permanent neurological deficit. Two aneurysms are still open at up to 30 months follow-up. Flow diversion was used in 2% of all endovascular treatments. Both our own poor results and the high complication rates reported in the literature have converted our initial enthusiasm to apprehension and hesitancy. The safety and efficacy profile of flow diversion should discourage the use of these devices in aneurysms that can be treated with other techniques.
Willem Jan van Rooij; Ratna S Bechan; Jo P Peluso; Menno Sluzewski
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Publication Detail:
Type:  Journal Article     Date:  2014-08-28
Journal Detail:
Title:  Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences     Volume:  20     ISSN:  1591-0199     ISO Abbreviation:  Interv Neuroradiol     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-09-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602695     Medline TA:  Interv Neuroradiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  428-35     Citation Subset:  IM    
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