Lukas Goertz1,2, Nina Hesse3, Thomas Liebig4, Wael Ahmad5, Nuran Abdullayev6, Boris Krischek7, Christoph Kabbasch6, Franziska Dorn4. 1. Department of Neuroradiology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany. lukas.goertz@uk-koeln.de. 2. Center for Neurosurgery, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany. lukas.goertz@uk-koeln.de. 3. Department of Radiology, LMU University Hospital of Munich, Munich, Germany. 4. Department of Neuroradiology, LMU University Hospital of Munich, Munich, Germany. 5. Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany. 6. Department of Neuroradiology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany. 7. Center for Neurosurgery, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.
Abstract
PURPOSE: The management of residual or persistent intracranial aneurysms after flow-diversion therapy is not well defined in the literature. In this multicentric study, we report clinical and angiographic outcomes of 11 patients that underwent retreatment for 12 aneurysms initially treated with flow-diverter stents. METHODS: The median patient age was 53 years. Aneurysms (median size, 7.3 mm) were located at the internal carotid artery in 9 cases, and at the posterior circulation in 3. Treatment strategies, complications, and angiographic outcome were retrospectively assessed. RESULTS: Retreatment was feasible in all cases and performed by overlapping flow-diverter implantation. Overall, 12 side vessels were covered during retreatment, whereof 10 (83.3%) remained patent until mid-term follow-up. There were no further technical or symptomatic complications and no treatment-related morbidity. Angiographic follow-up (median, 17 months) showed improved aneurysm occlusion in all patients. Complete or near-complete aneurysm occlusion was achieved in 11 aneurysms (91.7%). CONCLUSION: Required retreatment after failed flow-diversion therapy can be performed with adequate safety and efficacy by placement of additional flow-diverter stents.
PURPOSE: The management of residual or persistent intracranial aneurysms after flow-diversion therapy is not well defined in the literature. In this multicentric study, we report clinical and angiographic outcomes of 11 patients that underwent retreatment for 12 aneurysms initially treated with flow-diverter stents. METHODS: The median patient age was 53 years. Aneurysms (median size, 7.3 mm) were located at the internal carotid artery in 9 cases, and at the posterior circulation in 3. Treatment strategies, complications, and angiographic outcome were retrospectively assessed. RESULTS: Retreatment was feasible in all cases and performed by overlapping flow-diverter implantation. Overall, 12 side vessels were covered during retreatment, whereof 10 (83.3%) remained patent until mid-term follow-up. There were no further technical or symptomatic complications and no treatment-related morbidity. Angiographic follow-up (median, 17 months) showed improved aneurysm occlusion in all patients. Complete or near-complete aneurysm occlusion was achieved in 11 aneurysms (91.7%). CONCLUSION: Required retreatment after failed flow-diversion therapy can be performed with adequate safety and efficacy by placement of additional flow-diverter stents.