V Da Ros1,2, J Caroff2, A Rouchaud2, C Mihalea2,3, L Ikka2, J Moret2, L Spelle2,4. 1. From the Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy (V.D.R.), Policlinico Tor Vergata, Rome, Italy daros.valerio@gmail.com. 2. Interventional Neuroradiology NEURI Center (V.D.R., J.C., A.R., C.M., L.I., J.M., L.S.), Hôpital Bicêtre, Le Kremlin Bicêtre, France. 3. Department of Neurosurgery (C.M.), University of Medicine and Pharmacy "Victor Babes," Timisoara, Romania. 4. Université Paris-Sud XI (L.S.), Le Kremlin-Bicêtre, France.
Abstract
BACKGROUND AND PURPOSE: The treatment of wide-neck, large basilar apex aneurysms is challenging with either an endovascular or a surgical approach. The aim of the present study was to report our experience treating basilar apex aneurysms with flow-diverter stents and to evaluate their efficacy and safety profile in this specific anatomic condition. MATERIALS AND METHODS: We retrospectively analyzed data from all consecutive patients treated with flow-diverter stents at our institution between January 2011 and January 2015. Patients with large basilar apex aneurysms treated with a flow-diverter stent were included in the study. Clinical presentations, technical details, intra- and perioperative complications, and clinical and angiographic outcomes were recorded, with a midterm follow-up. RESULTS: Of the 175 aneurysms treated with flow-diverter stents at our institution, 5 patients (2 women and 3 men; age range, 44-58 years) received flow-diverter stent for basilar apex aneurysms. The mean follow-up after stent deployment was 21 months (range, 15-24 months). One patient died on day 31 from an early postprocedural midbrain hemorrhage. One patient had a right cerebellar hemispheric ischemic lesion with a transient cerebellar syndrome resolved within 24 hours without neurologic sequelae at the latest follow-up. The mRS was 0 in 4 patients and 6 in 1 patient at last follow-up. CONCLUSIONS: Flow diversion is a feasible technique with an efficacy demonstrated at a midterm follow-up, especially in the case of basilar apex aneurysm recurrences after previous endovascular treatments. Concern about its safety profile still exists.
BACKGROUND AND PURPOSE: The treatment of wide-neck, large basilar apex aneurysms is challenging with either an endovascular or a surgical approach. The aim of the present study was to report our experience treating basilar apex aneurysms with flow-diverter stents and to evaluate their efficacy and safety profile in this specific anatomic condition. MATERIALS AND METHODS: We retrospectively analyzed data from all consecutive patients treated with flow-diverter stents at our institution between January 2011 and January 2015. Patients with large basilar apex aneurysms treated with a flow-diverter stent were included in the study. Clinical presentations, technical details, intra- and perioperative complications, and clinical and angiographic outcomes were recorded, with a midterm follow-up. RESULTS: Of the 175 aneurysms treated with flow-diverter stents at our institution, 5 patients (2 women and 3 men; age range, 44-58 years) received flow-diverter stent for basilar apex aneurysms. The mean follow-up after stent deployment was 21 months (range, 15-24 months). One patient died on day 31 from an early postprocedural midbrain hemorrhage. One patient had a right cerebellar hemispheric ischemic lesion with a transient cerebellar syndrome resolved within 24 hours without neurologic sequelae at the latest follow-up. The mRS was 0 in 4 patients and 6 in 1 patient at last follow-up. CONCLUSIONS: Flow diversion is a feasible technique with an efficacy demonstrated at a midterm follow-up, especially in the case of basilar apex aneurysm recurrences after previous endovascular treatments. Concern about its safety profile still exists.
Authors: G Gascou; K Lobotesis; H Brunel; P Machi; C Riquelme; O Eker; A Bonafé; V Costalat Journal: AJNR Am J Neuroradiol Date: 2014-12-18 Impact factor: 3.825
Authors: I Szikora; Z Berentei; Z Kulcsar; M Marosfoi; Z S Vajda; W Lee; A Berez; P K Nelson Journal: AJNR Am J Neuroradiol Date: 2010-02-11 Impact factor: 3.825
Authors: R F Spetzler; M N Hadley; D Rigamonti; L P Carter; P A Raudzens; S A Shedd; E Wilkinson Journal: J Neurosurg Date: 1988-06 Impact factor: 5.115