Introduction Flow diverters (FDs) have dramatically altered the treatment of intracranial aneurysms. Several literature studies have demonstrated the safety and effectiveness of individual devices. However, in clinical practice, different FDs are used, for different aneurysms, ruptured and unruptured.

Aim of Study To assess the safety, long term angiographic and clinical outcomes in a real-world scenario.

Methods We retrospectively analyzed data from all consecutive patients with intracranial aneurysms treated with FDs at our tertiary center between January 2010 and December 2019. Clinical presentations, intra- and perioperative complications, and clinical and angiographic outcomes were recorded, with long-term follow-up. Logistic regression analysis was performed to evaluate for possible variables associated with aneurysm occlusion, and early ischemic stroke after FD.

Results A total 169 patients with 202 aneurysms were included. Seventeen aneurysms (8.4%) were ruptured. Technical success was achieved in 97.5% of cases. Aneurysm occlusion rates were 52.0% (64/123), 70.4% (88/125), and 81.5% (101/124) at 6 ,12 and 24-month follow-up, respectively. Intraprocedural complications occurred in 4.7% of patients, and postprocedural complications in 20.1%. The most frequent complication was ischemic stroke (14.9%), which was independently associated with older age and higher number of devices used.

Conclusion Our series suggests that treatment with FD is feasible in a wide spectrum of cases, including aneurysms in different locations, sizes and morphology, ruptured and non-ruptured, reflecting a real-world scenario. Although available devices may differ, they seem to demonstrate comparable and adequate safety and effectiveness.

Disclosure of Interest Nothing to disclose