The Fate of Side Branches Covered by Flow Diverters - results from 140 patients.

Related Articles

The Fate of Side Branches Covered by Flow Diverters - results from 140 patients.

World Neurosurg. 2017 Apr 21;:

Authors: Bhogal P, Ganslandt O, Bäzner H, Henkes H, Perez MA

Abstract
BACKGROUND: Flow diverter stents (FDS) are a recognised treatment option for intracranial aneurysms. There remain on-going concerns regarding the safety of FDS especially when it comes to the fate of covered side branches. We sought to report on the patency of side branches covered by FDS.
METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated with FDS for an unruptured saccular aneurysm of the clinoid, ophthalmic, and terminating segments of the internal carotid artery between September 2009 and July 2016. The aneurysm location, fundus size, and the state of covered branches at last angiography were recorded in comparison to pre-operative angiography.
RESULTS: We identified 140 patients, with 147 aneurysms, that met our inclusion criteria. Five patients had bilateral aneurysms. There were 31 male patients in our cohort (21.9%) and the mean average age was 56.2±13.7-years. Sixty-seven aneurysms arose from the communicating, 58 from the ophthalmic and 22 from the clinoidal segments. At last follow-up (mean 22.3months) 116 aneurysms were completely occluded (78.3%). On the most recent angiogram 7 ophthalmic (5.3%), 20 posterior communicating (42.6%), 0 anterior choroidal (0%), and 2 anterior cerebral arteries (14.3%) were completely occluded. Reduced vessel calibre was seen in 11 ophthalmic (8.3%), 3 posterior communicating (6.4%), 0 anterior choroidal and 6 anterior cerebral arteries (42.9%). One patient died during follow-up.
CONCLUSION: The side branch occlusion rate was 20% and included ophthalmic, posterior communicating and anterior cerebral arteries. Consistent with other studies we did not see occlusion of the anterior choroidal artery.

PMID: 28438653 [PubMed - as supplied by publisher]

http://ift.tt/2q6KZle