Sergio A Vargas1, Carlos Diaz1, Diego A Herrera1, Arthur B Dublin2. 1. Universidad de Antioquia, Department of Radiology, Medellin, Colombia. 2. University of California Davis Medical Center, Department of Diagnostic Radiology, Sacramento, CA.
Abstract
OBJECTIVE: To report a single-center experience in the endovascular management of cerebral aneurysms in children with stenting and flow-diversion techniques. METHODS: During a 7-year period, 5 male patients with six intracranial aneurysms (IA) were treated by endovascular therapy with stenting or flow-diversion. The average age was 11 years (range 6-18 years). RESULTS: The etiology of the aneurysms was vasculopathic in 3 cases (50%), traumatic in 2 patients (33.3%), and idiopathic in 1 case (16.7%). Two-thirds of the aneurysms were giant in size. The aneurysms were most frequently located in the anterior circulation (66.7%). Fifty percent of the aneurysms were treated with stenting and coiling, and 50% were treated with flow-diversion stents alone. After treatment, occlusion was graded as: partial in five aneurysms (88.3%) and complete in 1 case (16.7%). Most cases (83.3%) had a good outcome after the procedure. During follow-up, most aneurysms had progressive occlusion (80%), while the rest were unchanged (20%). Most stents and flow-diverter devices remained patent (80%). However, one Pipeline flow-diverter device in the Anterior cerebral artery (ACA) A2 segment had an asymptomatic occlusion. CONCLUSIONS: In this series, device-assisted endovascular techniques were a relatively safe and effective method of treatment of pediatric aneurysms. However, continued follow-up is required after treatment, because there are unsolved issues regarding the durability of flow-diverters and stents.
OBJECTIVE: To report a single-center experience in the endovascular management of cerebral aneurysms in children with stenting and flow-diversion techniques. METHODS: During a 7-year period, 5 male patients with six intracranial aneurysms (IA) were treated by endovascular therapy with stenting or flow-diversion. The average age was 11 years (range 6-18 years). RESULTS: The etiology of the aneurysms was vasculopathic in 3 cases (50%), traumatic in 2 patients (33.3%), and idiopathic in 1 case (16.7%). Two-thirds of the aneurysms were giant in size. The aneurysms were most frequently located in the anterior circulation (66.7%). Fifty percent of the aneurysms were treated with stenting and coiling, and 50% were treated with flow-diversion stents alone. After treatment, occlusion was graded as: partial in five aneurysms (88.3%) and complete in 1 case (16.7%). Most cases (83.3%) had a good outcome after the procedure. During follow-up, most aneurysms had progressive occlusion (80%), while the rest were unchanged (20%). Most stents and flow-diverter devices remained patent (80%). However, one Pipeline flow-diverter device in the Anterior cerebral artery (ACA) A2 segment had an asymptomatic occlusion. CONCLUSIONS: In this series, device-assisted endovascular techniques were a relatively safe and effective method of treatment of pediatric aneurysms. However, continued follow-up is required after treatment, because there are unsolved issues regarding the durability of flow-diverters and stents.
Authors: Mary In-Ping Huang Cobb; Ali R Zomorodi; Erik F Hauck; Tony P Smith; L Fernando Gonzalez Journal: Childs Nerv Syst Date: 2016-12-12 Impact factor: 1.475
Authors: Peyman Shirani; Saeedeh Mirbagheri; Maksim Shapiro; Eytan Raz; Ashkan Mowla; Bita Semsarieh; Howard A Riina; Peter K Nelson Journal: Interv Neurol Date: 2019-02-15
Authors: Sun Mo Nam; Donghwan Jang; Kyu-Chang Wang; Seung-Ki Kim; Ji Hoon Phi; Ji Yeoun Lee; Won-Sang Cho; Jeong Eun Kim; Hyun-Seung Kang Journal: J Korean Neurosurg Soc Date: 2019-08-30