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Hemorrhagic stroke
Case series
Use of flow diverters in the treatment of unruptured saccular aneurysms of the anterior cerebral artery
  1. P Bhogal1,
  2. R Martinez Moreno1,
  3. O Ganslandt2,
  4. H Bäzner3,
  5. H Henkes1,4,
  6. M Aguilar Perez1
  1. 1Neuroradiological Clinic, Neurocenter, Klinikum Stuttgart, Stuttgart, Germany
  2. 2Neurosurgical Clinic, Neurocenter, Klinikum Stuttgart, Stuttgart, Germany
  3. 3Neurological Clinic, Neurocenter, Klinikum Stuttgart, Stuttgart, Germany
  4. 4Medical Faculty, University Duisburg-Essen, Duisburg-Essen, Germany
  1. Correspondence to Dr P Bhogal, Neuroradiological Clinic, Neurocenter, Klinikum Stuttgart, Kriegsbergstrasse 60, Stuttgart 70174, Germany; bhogalweb{at}aol.com

Abstract

Background Few publications have dealt exclusively with the use of flow diverter stents for the treatment of aneurysms of the anterior cerebral artery (ACA).

Objective To determine the efficacy of flow-diverting stents in the treatment of small, unruptured aneurysms of the ACA.

Methods We retrospectively reviewed our database of prospectively collected information for all patients treated with flow diversion for an unruptured saccular aneurysm of the ACA between September 2009 and July 2016. The aneurysm fundus size, neck size, number and type of flow-diverting stent (FDS), complications, and follow-up data were recorded.

Results In total 26 patients, with 27 aneurysms were identified that matched our inclusion criteria (11 male and 15 female). The average age of the patients was 59.3 years (range 27–77 years). All patients, except one, had a single aneurysm affecting the ACA. Fourteen aneurysms were located on the left (51.9%). The average aneurysm fundus size was 2.9 mm (range 2–6 mm). Twenty patients had follow-up angiographic studies. In total, 16 aneurysms were completely excluded, 1 aneurysm showed a very small remnant, and no follow-up angiographic data are available for the remaining patients. One patient had a treatment-related complication.

Conclusions Treatment of aneurysms arising from the ACA with flow diverters is technically feasible and carries a high degree of success with low complication rate.

  • Aneurysm
  • Stent

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/neurintsurg-2016-012648

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    Footnotes

    • Twitter Follow Marta Perez at @MartaAguilarPe2

    • Contributors MAP, PB, RMM data gathering, manuscript preparation; OG, HB: review, editing; HH: guarantor, overall review, study design.

    • Competing interests MAP, PB, and RMM are proctors and consultants for phenox GmbH, and receive moderate financial compensation. HH is a co-founder and shareholder of phenox GmbH.

    • Provenance and peer review Not commissioned; externally peer reviewed.