Background Giant internal carotid artery (ICA) aneurysms in the cavernous segment can cause mass effect and a variety of cranial nerves palsies. With the introduction of flow diverting stents, a new option was added to the treatment paradigm.

Objective To assess efficacy, feasibility, and safety profile of flow diverters in treating giant ICA aneurysms.

Methods This is a retrospective case-series of giant cavernous aneurysms treated with flow diversion between 2012 and 2022 at our institution. Giant aneurysms were defined as aneurysms with a maximal diameter of ≥24mm.

Results Our case series comprised of 9 female patients with a mean age of 66.8 years ± 14.1. The mean aneurysm neck width was 7.1 mm ±1.5, mean maximal diameter was 25.1 mm ±4.9, and mean height was 18. 5 mm ± 7.2. Only 1 (11.1%) patient who presented with a ruptured aneurysms on admission, experienced a re-rupture during the post-operative duration and passed away. At final follow-up, 6 (85.7%) patients achieved complete aneurysm occlusion (RROC Grade I), 1 (14.3%) patient had a neck residue (RROC Grade II), recurrence rate was 0% and all patients had good functional outcome (mRS 0-2). The mean duration to final follow-up was 28.3 months ± 27.2.

Conclusion Compared to other endovascular and surgical techniques, flow diversion for giant cavernous ICA aneurysms can be a safe and effective treatment option. Further larger studies should be conducted to validate and strengthen our results.

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Abstract E-124 Figure 1

Disclosures K. El Naamani: None. S. Majmundar: None. R. Abbas: None. N. Herial: None. H. Zarzour: None. R. Schmidt: None. S. Tjoumakaris: 2; C; Medtronic, Microvention. R. Rosenwasser: None. P. Jabbour: 2; C; Medtronic, Microvention, Balt, Cerus Endovascular. M. Gooch: None. L. Mackenzie: None. O. Kozak: None. V. Schunemann: None.