Background Flow diverters have emerged in recent years as a safe and effective treatment for intracranial aneurysms, with expanding indications. The Derivo embolization device (DED) is a second-generation flow diverter with a surface finish that may reduce thrombogenicity. We report our multicenter experience evaluating its safety and efficacy.
Methods We retrospectively analyzed all patients treated with the DED in eight centers in Spain between 2016 and 2020. Demographics, clinical data, procedural complications, morbidity and aneurysm occlusion rates were collected.
Results A total of 209 patients with 250 aneurysms were treated (77.5% women). The majority of aneurysms were located in the internal carotid artery (86.8%) and most (69.2%) were small (<10 mm) with a median maximum diameter of 5.85 mm and median neck size of 4 mm. DED deployment was successful in all cases, despite two malfunctioning devices (1%). Major complications occurred in nine patients (4.3%), while mild neurologic clinical events were registered in 23 (11%); four patients died (1.9%). A total of 194 aneurysms had an angiographic follow-up at 6 months and showed complete aneurysm occlusion in 75% of cases. Twelve-month follow-up was available for 112 of the treated aneurysms, with a total occlusion rate of 83%.
Conclusion The DED is a second-generation surface-modified flow diverter that presents an option for treatment of intracranial aneurysms with comparable safety and efficacy to other available flow diverter devices. Nonetheless, risks are not negligible, and must be balanced against the natural history risk of cerebral aneurysms, considering the tendency to widen indications for treatment of smaller and less complex lesions in day-to-day use.
- Flow Diverter
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Collaborators Lucía Aja, Roger Barranco, Jordi Blasco, Víctor Cuba, Juan Chaviano, Óscar Chirife, Jose Díaz-Pérez, María Ángeles De Miquel, Gonzalo De Paco, Blanca García-Villalba, José David Guio, José María Jiménez, Alfonso López-Frías, Antonio López-Rueda, Guillermo Parrilla Reverter, Carlos Pérez-García, Isabel Rodríguez-Caamaño, Carmen Soriano.
Contributors Substantial contributions to the conception and design of the work: AT, CP. Acquisition, analysis, or interpretation of data for the work: all authors. Drafting the manuscript: AT, CP, ER, MR, LLG. Critical revision of the manuscript for relevant intellectual content: all authors. Final approval of the manuscript: all authors.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests AT has received personal fees from Anaconda Biomed, Balt, Medtronic, Perflow, and Stryker.
Provenance and peer review Not commissioned; externally peer reviewed.
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