R C Puffer1, M Piano2, G Lanzino3, L Valvassori2, D F Kallmes4, L Quilici2, H J Cloft4, E Boccardi2. 1. From the Departments of Neurosurgery (R.C.P.). 2. Division of Neuroradiology (M.P., L.V., L.Q., E.B.), Ospedale Niguarda, Milano, Italy. 3. Radiology (G.L., D.F.K., H.J.C.), Mayo Clinic, Rochester, Minnesota lanzino.giuseppe@mayo.edu. 4. Radiology (G.L., D.F.K., H.J.C.), Mayo Clinic, Rochester, Minnesota.
Abstract
BACKGROUND AND PURPOSE: Aneurysms of the cavernous segment of the ICA are difficult to treat with standard endovascular techniques, and ICA sacrifice achieves a high rate of occlusion but carries an elevated level of surgical complications and risk of de novo aneurysm formation. We report rates of occlusion and treatment-related data in 44 patients with cavernous sinus aneurysms treated with flow diversion. MATERIALS AND METHODS: Patients with cavernous segment aneurysms treated with flow diversion were selected from a prospectively maintained data base of patients from 2009 to the present. Demographic information, treatment indications, number/type of flow diverters placed, outcome, complications (technical or clinical), and clinical/imaging follow-up data were analyzed. RESULTS: We identified 44 patients (37 females, 7 males) who had a flow diverter placed for treatment of a cavernous ICA aneurysm (mean age, 57.2; mean aneurysm size, 20.9 mm). The mean number of devices placed per patient was 2.2. At final angiographic follow-up (mean, 10.9 months), 71% had complete occlusion, and of those with incomplete occlusion, 40% had minimal remnants (<3 mm). In symptomatic patients, complete resolution or significant improvement in symptoms was noted in 90% at follow-up. Technical complications (which included, among others, vessel perforation in 4 patients, groin hematoma in 2, and asymptomatic carotid occlusion in 1) occurred in approximately 36% of patients but did not result in any clinical sequelae immediately or at follow-up. CONCLUSIONS: Our series of flow-diversion treatments achieved markedly greater rates of complete occlusion than coiling, with a safety profile that compares favorably with that of carotid sacrifice.
BACKGROUND AND PURPOSE:Aneurysms of the cavernous segment of the ICA are difficult to treat with standard endovascular techniques, and ICA sacrifice achieves a high rate of occlusion but carries an elevated level of surgical complications and risk of de novo aneurysm formation. We report rates of occlusion and treatment-related data in 44 patients with cavernous sinus aneurysms treated with flow diversion. MATERIALS AND METHODS:Patients with cavernous segment aneurysms treated with flow diversion were selected from a prospectively maintained data base of patients from 2009 to the present. Demographic information, treatment indications, number/type of flow diverters placed, outcome, complications (technical or clinical), and clinical/imaging follow-up data were analyzed. RESULTS: We identified 44 patients (37 females, 7 males) who had a flow diverter placed for treatment of a cavernous ICA aneurysm (mean age, 57.2; mean aneurysm size, 20.9 mm). The mean number of devices placed per patient was 2.2. At final angiographic follow-up (mean, 10.9 months), 71% had complete occlusion, and of those with incomplete occlusion, 40% had minimal remnants (<3 mm). In symptomatic patients, complete resolution or significant improvement in symptoms was noted in 90% at follow-up. Technical complications (which included, among others, vessel perforation in 4 patients, groin hematoma in 2, and asymptomatic carotid occlusion in 1) occurred in approximately 36% of patients but did not result in any clinical sequelae immediately or at follow-up. CONCLUSIONS: Our series of flow-diversion treatments achieved markedly greater rates of complete occlusion than coiling, with a safety profile that compares favorably with that of carotid sacrifice.
Authors: Robert J McDonald; Jennifer S McDonald; David F Kallmes; Giuseppe Lanzino; Harry J Cloft Journal: Interv Neuroradiol Date: 2015-02 Impact factor: 1.610
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Authors: David F Kallmes; Waleed Brinjikji; Edoardo Boccardi; Elisa Ciceri; Orlando Diaz; Rabih Tawk; Henry Woo; Pascal Jabbour; Felipe Albuquerque; Rene Chapot; Alain Bonafe; Shervin R Dashti; Josser E Delgado Almandoz; Curtis Given; Michael E Kelly; DeWitte T Cross; Gary Duckwiler; Nasser Razack; Ciaran J Powers; Sebastian Fischer; Demetrius Lopes; Mark R Harrigan; Daniel Huddle; Raymond Turner; Osama O Zaidat; Luc Defreyne; Vitor Mendes Pereira; Saruhan Cekirge; David Fiorella; Ricardo A Hanel; Pedro Lylyk; Cameron McDougall; Adnan Siddiqui; Istvan Szikora; Elad Levy Journal: Interv Neurol Date: 2016-05-26
Authors: Mehdi Abbasi; Luis E Savasatano; Waleed Brinjikji; Kevin M Kallmes; Nick Mikoff; Natalie Reierson; Mohamed Abdelmegeed; John Pederson; Beth Warren; Jillienne C Touchette; Sarah Khan; Shelby Kamrowski; Averi Barrett; David F Kallmes; Ramanathan Kadirvel Journal: Interv Neuroradiol Date: 2021-06-22 Impact factor: 1.764