J Caroff1, H Neki2, C Mihalea3, F D'Argento4, H Abdel Khalek5, L Ikka6, J Moret6, L Spelle6. 1. From the Department of Interventional Neuroradiology (J.C., H.N., C.M., H.A.K., L.I., J.M., L.S.), Neuro Brain Vascular Center, Hôpital Bicêtre, APHP, Paris Sud Université, France Jildaz.caroff@bjn.aphp.fr. 2. From the Department of Interventional Neuroradiology (J.C., H.N., C.M., H.A.K., L.I., J.M., L.S.), Neuro Brain Vascular Center, Hôpital Bicêtre, APHP, Paris Sud Université, France Department of Neurosurgery (H.N.), Saitama University, Saitama, Japan. 3. From the Department of Interventional Neuroradiology (J.C., H.N., C.M., H.A.K., L.I., J.M., L.S.), Neuro Brain Vascular Center, Hôpital Bicêtre, APHP, Paris Sud Université, France Department of Neurosurgery (C.M.), University of Medicine and Pharmacy "Victor Babes," Timisoara, Romania. 4. Department of Bioimaging and Radiological Sciences (F.D.), Policlinico "A. Gemelli," Rome, Italy. 5. From the Department of Interventional Neuroradiology (J.C., H.N., C.M., H.A.K., L.I., J.M., L.S.), Neuro Brain Vascular Center, Hôpital Bicêtre, APHP, Paris Sud Université, France Department of Neuropsychiatry (H.A.K.), Tanta University Hospital, Tanta, Egypt. 6. From the Department of Interventional Neuroradiology (J.C., H.N., C.M., H.A.K., L.I., J.M., L.S.), Neuro Brain Vascular Center, Hôpital Bicêtre, APHP, Paris Sud Université, France.
Abstract
BACKGROUND AND PURPOSE: The flow-diverter stent has been proved a feasible, safe, and efficient technique, particularly for the treatment of large and broad-neck carotid siphon aneurysms. Wide-neck bifurcation aneurysms remain, in some cases, a challenge for neurointerventionalists. We report the outcomes of the treatment of saccular middle cerebral artery bifurcation aneurysms with flow diversion in our institution. MATERIALS AND METHODS: From the institution data base, all saccular, nondissecting MCA bifurcation aneurysms, treated with flow-diverter stents, were retrospectively reviewed. Technical issues, immediate posttreatment and follow-up angiographic findings, and clinical outcomes were assessed. RESULTS: Fourteen patients with 15 aneurysms were included in the study. Ischemic complications, as confirmed by MR imaging, occurred in 6 patients (43%). Procedure-related morbidity and mortality at last follow-up were 21% and 0%, respectively. Angiographic follow-up was available for 13 aneurysms, with a mean follow-up of 16 months. Complete occlusion was obtained for 8 aneurysms (62%). CONCLUSIONS: Compared with other available therapeutic options, the flow-diverter stent does not appear to be a suitable solution for the treatment of saccular MCA bifurcation aneurysms.
BACKGROUND AND PURPOSE: The flow-diverter stent has been proved a feasible, safe, and efficient technique, particularly for the treatment of large and broad-neck carotid siphon aneurysms. Wide-neck bifurcation aneurysms remain, in some cases, a challenge for neurointerventionalists. We report the outcomes of the treatment of saccular middle cerebral artery bifurcation aneurysms with flow diversion in our institution. MATERIALS AND METHODS: From the institution data base, all saccular, nondissecting MCA bifurcation aneurysms, treated with flow-diverter stents, were retrospectively reviewed. Technical issues, immediate posttreatment and follow-up angiographic findings, and clinical outcomes were assessed. RESULTS: Fourteen patients with 15 aneurysms were included in the study. Ischemic complications, as confirmed by MR imaging, occurred in 6 patients (43%). Procedure-related morbidity and mortality at last follow-up were 21% and 0%, respectively. Angiographic follow-up was available for 13 aneurysms, with a mean follow-up of 16 months. Complete occlusion was obtained for 8 aneurysms (62%). CONCLUSIONS: Compared with other available therapeutic options, the flow-diverter stent does not appear to be a suitable solution for the treatment of saccular MCA bifurcation aneurysms.
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