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E-030 Endovascular Treatment with Flow Diverter of Recanalized and Multitreated Aneurysms Initially Treated by Endovascular Approach
  1. L Pierot1,
  2. A Benaissa1,
  3. A Januel2,
  4. D Herbreteau3,
  5. J Berge4,
  6. M Aggour5,
  7. C Cognard2
  1. 1Radiology, Hôpital Maison-Blanche, Reims, France
  2. 2Neuroradiology, CHU Toulouse, Toulouse, France
  3. 3Neuroradiology, CHU Tours, Tours, France
  4. 4Neuroradiology, CU Bordeaux, Bordeaux, France
  5. 5Neuroradiology, CHU Saint-Etienne, Saint-Etienne, France

Abstract

Background and purpose To evaluate the feasibility, safety, and efficacy of endovascular treatment with flow diverters (FD) in patients with recanalised and multitreated aneurysms, in a retrospective, multicenter, single-arm study.

Materials and methods The study included 29 patients with 29 recanalised aneurysms who were treated by FDs (Silk or Pipeline device). Per and post procedural complications and morbidity and mortality rates were evaluated. Additionally, functional outcomes (mRS) at 1 month (short-term) and 3–4 months (mid-term) were compared with pre-operative mRS (before the procedure). Mid-term angiographic follow-up was performed assessing aneurismal occlusion by a 3-grades scale (complete occlusion, neck remnant, aneurysm remnant).

Results FD placement was achieved in all the patients. Two misdeployments of the FD necessitated balloon dilatation in two patients associated with stent delivery in one patient. Permanent morbidity related to treatment was 6.9% (2/29), transient morbidity was 10.3% (3/29) and mortality due to treatment was 0.0% (0/29). One patient died from a myocardial infarct four weeks after the procedure. 25/29 (86.2%) patients had final good functional outcome, 26/29 (89.7%) patients had unchanged functional outcome, whereas 2/29 (6.9%) patients had clinical worsening. Angiographic follow-up showed complete occlusion in 17/28 patients (60.7%), neck remnants in 6/28 patients (21.4%) and residual aneurysms in 5/28 subjects (17.9%).

Conclusion Flow diverter placement is feasible and safe in patients with recanalised and multitreated aneurysms. The procedure is associated with a high percentage of good functional outcomes as well as good anatomical results at mid-term (82.1%).

Disclosures L. Pierot: 2; C; Covidien, Microvention, Stryker. A. Benaissa: None. A. Januel: None. D. Herbreteau: None. J. Berge: None. M. Aggour: None. C. Cognard: None.

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