M A Möhlenbruch1, C Herweh2, L Jestaedt2, S Stampfl2, S Schönenberger3, P A Ringleb3, M Bendszus2, M Pham2. 1. From the Departments of Neuroradiology (M.A.M., C.H., L.J., S. Stampfl, M.B., M.P.) markus.moehlenbruch@med.uni-heidelberg.de. 2. From the Departments of Neuroradiology (M.A.M., C.H., L.J., S. Stampfl, M.B., M.P.). 3. Neurology (S. Schönenberger, P.A.R.); University of Heidelberg Medical Center, Heidelberg, Germany.
Abstract
BACKGROUND AND PURPOSE: Flow-diverter stents are emerging for the endovascular treatment of difficult-to-treat or otherwise untreatable cerebral aneurysms (wide-neck, fusiform, dissecting, blisterlike, or giant). We assessed the clinical safety and efficacy of the Flow-Redirection Endoluminal Device. MATERIALS AND METHODS: This was an institutional review board-approved single-center observational clinical study in 29 patients with 34 aneurysms elected to be treated by endovascular intervention. After providing informed consent, patients were included according to the following criteria: aneurysm fundus-to-neck ratio <2 or neck diameter >4 mm, fusiform, dissecting, or giant aneurysms. The primary end point for clinical safety was the absence of death, absence of major or minor stroke, and absence of transient ischemic attack. The primary end point for treatment efficacy was complete angiographic occlusion according to the O'Kelly Marotta grading scale immediately after the procedure and at follow-up after 3 and 6 months (O'Kelly Marotta D: complete occlusion). RESULTS: The Flow-Redirection Intraluminal Device deployment was technically successful in all cases. In 26/29 (89%) of patients, the primary end point of safety was reached; in the 3 remaining patients, 1 disabling ischemic stroke and 2 minor strokes with complete recovery at follow-up were observed. Angiographic (DSA and MRA) and clinical follow-up were available after 3 months in 29/29 (100%) and after 6 months in 25/29 (86%) patients (after 6 months, only MRA follow-up was performed according to our study protocol and institutional standard). At 3-month follow-up, complete occlusion was reached in 19/34 aneurysms (O'Kelly Marotta D: 19/34; 56%). At 6-month follow-up, aneurysm occlusion was complete in 22/30 aneurysms (O'Kelly Marotta D: 22/30; 73%). CONCLUSIONS: Deployment of the Flow-Redirection Intraluminal Device flow-diverter stent is safe and effective in the treatment of difficult-to-treat or otherwise untreatable intracranial aneurysms.
BACKGROUND AND PURPOSE: Flow-diverter stents are emerging for the endovascular treatment of difficult-to-treat or otherwise untreatable cerebral aneurysms (wide-neck, fusiform, dissecting, blisterlike, or giant). We assessed the clinical safety and efficacy of the Flow-Redirection Endoluminal Device. MATERIALS AND METHODS: This was an institutional review board-approved single-center observational clinical study in 29 patients with 34 aneurysms elected to be treated by endovascular intervention. After providing informed consent, patients were included according to the following criteria: aneurysm fundus-to-neck ratio <2 or neck diameter >4 mm, fusiform, dissecting, or giant aneurysms. The primary end point for clinical safety was the absence of death, absence of major or minor stroke, and absence of transient ischemic attack. The primary end point for treatment efficacy was complete angiographic occlusion according to the O'Kelly Marotta grading scale immediately after the procedure and at follow-up after 3 and 6 months (O'Kelly Marotta D: complete occlusion). RESULTS: The Flow-Redirection Intraluminal Device deployment was technically successful in all cases. In 26/29 (89%) of patients, the primary end point of safety was reached; in the 3 remaining patients, 1 disabling ischemic stroke and 2 minor strokes with complete recovery at follow-up were observed. Angiographic (DSA and MRA) and clinical follow-up were available after 3 months in 29/29 (100%) and after 6 months in 25/29 (86%) patients (after 6 months, only MRA follow-up was performed according to our study protocol and institutional standard). At 3-month follow-up, complete occlusion was reached in 19/34 aneurysms (O'Kelly Marotta D: 19/34; 56%). At 6-month follow-up, aneurysm occlusion was complete in 22/30 aneurysms (O'Kelly Marotta D: 22/30; 73%). CONCLUSIONS: Deployment of the Flow-Redirection Intraluminal Device flow-diverter stent is safe and effective in the treatment of difficult-to-treat or otherwise untreatable intracranial aneurysms.
Authors: Breigh Nonte Roszelle; M Haithem Babiker; Walter Hafner; L Fernando Gonzalez; Felipe C Albuquerque; David H Frakes Journal: J Neurointerv Surg Date: 2012-06-26 Impact factor: 5.836
Authors: Andrew Molyneux; Richard Kerr; Irene Stratton; Peter Sandercock; Mike Clarke; Julia Shrimpton; Rury Holman Journal: Lancet Date: 2002-10-26 Impact factor: 79.321
Authors: Jean Raymond; François Guilbert; Alain Weill; Stavros A Georganos; Louis Juravsky; Anick Lambert; Julie Lamoureux; Miguel Chagnon; Daniel Roy Journal: Stroke Date: 2003-05-29 Impact factor: 7.914
Authors: A Rouchaud; C Ramana; W Brinjikji; Y-H Ding; D Dai; T Gunderson; J Cebral; D F Kallmes; R Kadirvel Journal: AJNR Am J Neuroradiol Date: 2016-07-07 Impact factor: 3.825
Authors: C Ulfert; J Pfaff; S Schönenberger; J Bösel; C Herweh; M Pham; M Bendszus; M Möhlenbruch Journal: Clin Neuroradiol Date: 2016-09-16 Impact factor: 3.649
Authors: Neeraj Ramesh Mahboobani; Wing Ho Chong; Samuel Siu Kei Lam; Jimmy Chi Wai Siu; Chong Boon Tan; Yiu Chung Wong Journal: Neurointervention Date: 2017-03-06
Authors: G Foa Torres; F Roca; A Noguera; J Godes; S Petrocelli; I Aznar; S Ales; P Muszynski; R Maehara; M Vicente; J M Pumar Journal: Interv Neuroradiol Date: 2018-05-02 Impact factor: 1.610