Azzedine Benaissa1, Anne-Christine Januel2, Denis Herbreteau3, Jérôme Berge4, Mohamed Aggour5, Krzysztof Kadziolka1, Christophe Cognard2, Laurent Pierot1. 1. Department of Neuroradiology, Centres Hospitaliers Universitaires de Reims, Reims, France. 2. Department of Neuroradiology, Centres Hospitaliers Universitaires de Toulouse, Toulouse, France. 3. Department of Neuroradiology, Centres Hospitaliers Universitaires de Tours, Tours, France. 4. Department of Neuroradiology, Centres Hospitaliers Universitaires de Bordeaux, Bordeaux, France. 5. Department of Neuroradiology, Centres Hospitaliers Universitaires de Saint-Etienne, Saint-Etienne, France.
Abstract
PURPOSE: To evaluate the feasibility, safety and efficacy of endovascular treatment with flow diverters in patients with recanalized and multitreated aneurysms in a retrospective, multicenter, single-arm study. METHODS: The study included 29 patients with 29 recanalized aneurysms who were treated by flow diverters (Silk or Pipeline devices). Pre- and post-procedural complications and morbidity and mortality rates were evaluated and functional outcomes (modified Rankin Score (mRS)) at 1 month (short-term) and 3-4 months (mid-term) were compared with preoperative mRS (before the procedure). Mid-term angiographic follow-up was performed assessing aneurysmal occlusion by the Montreal scale (complete occlusion, neck remnant, aneurysm remnant). RESULTS: Placement of the flow diverters was achieved in all patients. Two misdeployments of the flow diverters necessitated balloon dilation in two patients, which was associated with stent delivery in one patient. Permanent morbidity related to treatment was 6.9% (2/29), transient morbidity was 10.3% (3/29) and there were no deaths resulting from the treatment. One patient died from a myocardial infarct 4 weeks after the procedure. 25/29 patients (86.2%) had a good final functional outcome, 26/29 (89.7%) had an unchanged functional outcome and 2/29 patients (6.9%) had clinical worsening. Angiographic follow-up showed complete occlusion in 17/28 patients (60.7%), neck remnants in 6/28 patients (21.4%) and residual aneurysms in 5/28 (17.9%). CONCLUSIONS: Flow diverter placement is feasible and safe in patients with recanalized and multitreated aneurysms. The procedure is associated with a high percentage of good functional outcomes as well as good mid-term anatomical results (82.1%). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
PURPOSE: To evaluate the feasibility, safety and efficacy of endovascular treatment with flow diverters in patients with recanalized and multitreated aneurysms in a retrospective, multicenter, single-arm study. METHODS: The study included 29 patients with 29 recanalized aneurysms who were treated by flow diverters (Silk or Pipeline devices). Pre- and post-procedural complications and morbidity and mortality rates were evaluated and functional outcomes (modified Rankin Score (mRS)) at 1 month (short-term) and 3-4 months (mid-term) were compared with preoperative mRS (before the procedure). Mid-term angiographic follow-up was performed assessing aneurysmal occlusion by the Montreal scale (complete occlusion, neck remnant, aneurysm remnant). RESULTS: Placement of the flow diverters was achieved in all patients. Two misdeployments of the flow diverters necessitated balloon dilation in two patients, which was associated with stent delivery in one patient. Permanent morbidity related to treatment was 6.9% (2/29), transient morbidity was 10.3% (3/29) and there were no deaths resulting from the treatment. One patient died from a myocardial infarct 4 weeks after the procedure. 25/29 patients (86.2%) had a good final functional outcome, 26/29 (89.7%) had an unchanged functional outcome and 2/29 patients (6.9%) had clinical worsening. Angiographic follow-up showed complete occlusion in 17/28 patients (60.7%), neck remnants in 6/28 patients (21.4%) and residual aneurysms in 5/28 (17.9%). CONCLUSIONS: Flow diverter placement is feasible and safe in patients with recanalized and multitreated aneurysms. The procedure is associated with a high percentage of good functional outcomes as well as good mid-term anatomical results (82.1%). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: A Benaissa; C Tomas; F Clarençon; N Sourour; D Herbreteau; L Spelle; S Gallas; A-C Januel; A L Gaultier; L Pierot Journal: AJNR Am J Neuroradiol Date: 2015-10-29 Impact factor: 3.825
Authors: Jean-Christophe Gentric; Robert Fahed; Tim E Darsaut; Igor Salazkin; Daniel Roy; Jean Raymond Journal: Interv Neuroradiol Date: 2016-02-17 Impact factor: 1.610
Authors: Francesco Briganti; Giuseppe Leone; Lorenzo Ugga; Mariano Marseglia; Antonio Macera; Andrea Manto; Luigi Delehaye; Maurizio Resta; Mariachiara Resta; Nicola Burdi; Nunzio Paolo Nuzzi; Ignazio Divenuto; Ferdinando Caranci; Mario Muto; Domenico Solari; Paolo Cappabianca; Francesco Maiuri Journal: J Neurointerv Surg Date: 2016-07-20 Impact factor: 5.836