Introduction Optimal sizing of a PED leads to more metal coverage across the aneurysm inflow and therefore a higher rate of aneurysm occlusion. Traditionally longer stent deployment spans a more variable parent artery diameter. We hypothesize that deploying shorter length PEDs, while being more technically demanding, may offer a more optimal metal surface coverage as it is sized to a shorter, more uniform in diameter parent artery segment. We aim to investigate the efficacy and safety of treating UIAs with very short (10 mm) PEDs.

Methods We performed a retrospective chart review for UIAs treated at our institution from January 2013 to March 2024. Aneurysms that underwent 10 mm (flow divertor) FD placement were included. Primary outcomes were Raymond Roy Occlusion Classification and modified Rankin Scale (mRS) at last follow-up. Secondary outcomes included intraprocedural and postoperative complications, retreatment rate, and mortality.

Results 24 aneurysms underwent embolization with 10 mm FDs. Patients were mostly female (75%), median age 59.4 (41.16 - 80.10). 4 (16.7%) of the aneurysms were multilobulated and 1 was fusiform morphology. The median of maximum diameter of the aneurysm was 3.40 (1 - 8.4) mm. All cases were elective treatments with a median of 4.50 (0.03 - 20.6) months from diagnosis to treatment. Transradial access was used in 9 cases. Complete occlusion was achieved in 18 (94.74%) of the 19 radiologically evaluated aneurysms. One case had stable-residual neck filling at 18-month follow-up. There was one case of retreatment, no mortality, and no evidence of delayed aneurysm rupture. One case presented with thromboembolic complications after FD placement. Of the 20 patients with clinical follow data, none experienced a change from admission mRS.

Conclusion These preliminary findings suggest the deployment of very short (10 mm) PEDs is a safe and effective method for achieving complete aneurysmal occlusion.

Disclosures M. Sowlat: None. R. Abo Kasem: None. C. Cunningham: None. J. Isidor: None. H. Hughes: None. H. Matsukawa: 6; C; received a lecture fee from Daiichi-Sankyo and Stryker and consulting services fee from B. Braun. S. Elawady: None. A. Orscelik: None. A. Spiotta: 2; C; Consultant for Penumbra, Terumo, RapidAI, Cerenovus.