Background Endovascular approach is one of the ways to successfully treat cerebral aneurysms. Currently, there are various techniques and devices to increase the radicality of endovascular treatment. Despite the variety of available techniques, in recent years, flow diverts (FDs) have been increasingly preferred as a method for treating cerebral aneurysms.

Materials and Methods From January 2011 to March 2023 at E.Meshalkin National Medical Research Center, Novosibirsk, and Federal Center of Brain Research and Neurotechnologies, Moscow, 3803 endovascular operations to treat cerebral aneurysms were performed. 1009 (26.4%) FDs were implanted, and in the rest of the cases, the patients were treated using other embolization techniques. A retrospective analysis of the results obtained with FDs was carried out.

Results The technical success was 96.8%. The frequency of at which FDs were preferred to other techniques to treat cerebral aneurysms for 2011-2015 was 16.7% (n=164), and 28.1% (n=489) for 2016-2020. In 2021, FDs were implanted in 29.6% (n=149) of cases. From 2022 to March 2022, this technique was used in 36.4% (n=227) of the operations performed. According to the control studies (at median 9 months), total occlusion in the entire series has been achieved in 78.1% of cases (n=788), while some patients (n=164) are still waiting for their controls to be performed. For all FD interventions, a severe neurological deficit has comprised 1.09%, and mortality 0.4%.

Conclusion FD implantation is an effective and safe endovascular technique to treat cerebral aneurysms. Our experience shows that in recent years there has been a trend towards an increase in the number of implanted FDs if compared to other applied techniques without reducing the radicality and safety of endovascular treatment. The variety of currently available FDs, their technical capabilities, and improved delivery catheters make the embolization more convenient, reduce the operation time as well as the radiation and contrast loads. However, despite FD’s apparent simplicity, the need for antiplatelet therapy in the postoperative period and the restrictions on their use in the distal parts of the Willis circle and bifurcation aneurysms, not to mention their high price, still limit application of this treatment method, so further studies are required to expand the indications for the use of FDs.

Disclosures K. Orlov: None. N. Strelnikov: None. V. Berestov: None. A. Somova: None. A. Brusyanskaya: None.