Expanding the use of flow diverters beyond their initial indication: treatment of small unruptured aneurysms.

Abstract

BACKGROUND:

Experience with the endovascular treatment of unruptured small intracranial aneurysms by flow diverter devices is still limited.

OBJECTIVE:

To assess the safety and efficacy of the SILK flow diverter (SFD) in the treatment of small unruptured cerebral aneurysms (<10 mm).

METHODS:

We performed a retrospective review of a prospectively maintained database of patients treated with a SFD between July 2008 and December 2013 at 4 institutions in Spain to identify all patients with small unruptured aneurysms (<10 mm). Data for patient demographics, aneurysm characteristics, and technical procedures were analyzed. Angiographic and clinical findings were recorded during the procedure and at 6- and 12-month follow-ups.

RESULTS:

A total of 109 small aneurysms were treated with a SFD in 104 patients (78 women; 26 men; mean, median, and range of age: 55.2, 57.1, and 19-80 years, respectively). A total of 60 patients were asymptomatic (57.7%). All except 7 aneurysms (6.4%) arose from the anterior circulation. The mean size of the aneurysms was 4.7±1.9 mm. At 6 months, the neuromorbidity and neuromortality rates were 2.9% and 0.9%, respectively. Imaging at the 12-month follow-up showed complete occlusion, neck remnants, and residual aneurysm in 88.5% (69/78), 7.7% (6/78), and 3.3% (3/78) of cases, respectively. No delayed hemorrhage occurred.

CONCLUSIONS:

The findings suggest that the indications for SFD can be safely extended to small intracranial aneurysms.

• Authors: J M Pumar, A Mosqueira, H Cuellar, B Dieguez, L Guimaraens, J Masso, S Miralbes, M Blanco-Ulla, M Souto-Bayarri, F Vazquez-Herrero
• Journal: Journal of neurointerventional surgery (J Neurointerv Surg) Vol. 10 Issue 3 Pg. 245-248 (Mar 2018) ISSN: 1759-8486 [Electronic] England
• PMID: 28490608 (Publication Type: Journal Article)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Topics

• Adult
• Aged
• Aged, 80 and over
• Cerebral Angiography (methods)
• Databases, Factual
• Embolization, Therapeutic (methods)
• Endovascular Procedures (instrumentation, methods)
• Female
• Humans
• Intracranial Aneurysm (diagnostic imaging, therapy)
• Male
• Middle Aged
• Prospective Studies
• Retrospective Studies
• Stents (statistics & numerical data)
• Treatment Outcome