Endovascular treatment of intracranial aneurysms with flow-diverter stents: preliminary single-centre experience

Radiol Med. 2013 Sep;118(6):971-83. doi: 10.1007/s11547-013-0944-9. Epub 2013 Jun 26.

Abstract

Purpose: This paper reports our preliminary experience with the endovascular treatment of intracranial aneurysms using flow-diverter stents (FDs) and compares it with the literature data.

Materials and methods: From May 2009 to April 2012, 28 patients (6 men and 22 women; mean age, 54 years) with a total of 35 aneurysms were treated with FDs. We evaluated postprocedural technical success and long-term efficacy, with follow-up examinations performed at 3-7 days [computed tomography (CT)/magnetic resonance (MR) angiography] and at 3, 6 and 12 months (digital subtraction angiography, DSA). A total of 43 FDs were placed, 36 Pipeline and 7 Silk.

Results: A total of 30 procedures were performed (two patients were treated twice). Technical success was 96.6%, with one case of postprocedural death; the aneurysm exclusion rate at 3, 6 and 12 months was 60%, 73% and 89%, respectively. There was no case of acute stent thrombosis, and only two cases of nonsignificant stenosis. All covered side branches were patent, except one case of steno-occlusion of the ophthalmic artery.

Conclusions: Our results are consistent with the literature and demonstrate the effectiveness and safety of FDs in selected cases of cerebral aneurysm (wide neck, fusiform, blister-like).

MeSH terms

  • Angiography, Digital Subtraction
  • Cerebral Angiography
  • Clopidogrel
  • Contrast Media
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / surgery*
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / administration & dosage
  • Stents*
  • Ticlopidine / administration & dosage
  • Ticlopidine / analogs & derivatives
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Contrast Media
  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine