Article Text
Abstract
Introduction Bioresorbable vascular scaffolds (BVS) have not been utilized in the cerebrovascular circulation yet. We report the mid-term results with these devices in interventional neuroradiology.
Materials and Methods A retrospective review of clinical presentations, imaging findings and follow-up results of all patients treated using a BVS by our neurovascular team was carried out using hospital charts and hospital radiographic archive system. Patients who were likely to benefit the advantages of BVS were carefully selected and the scaffold was deployed only if the patient had a non-tortuous cerebrovascular anatomy suitable for the navigation of the BVS.
Results 9 patients were treated with Absorb or DeSolve scaffolds without permanent morbidity or mortality and technical success. Five had cerebrovascular stenosis, 4 underwent scaffold-assisted coiling for aneurysms. At a mean follow-up of 22.3 months, 1 parent artery in the aneurysm group was occluded and otherwise there was no significant scaffold stenosis. Positive arterial remodeling, almost in the form of a fusiform aneurysm, was demonstrated in one patient. In 2 patients treated for stenosis, transient intraarterial filling defects resembling BVS struts (“stent silhouette”) was demonstrated on early follow-up angiograms. This finding later disappeared. In the patient with incidentally found parent artery occlusion who was judged to have detailed her internal carotid bifurcation and in the patient with positive remodeling, we were able to discontinue all antiplatelet medications at long term without any consequence.
Conclusion Absorbable device technology has prospective applications in interventional neuroradiology. BVS should be optimized for cerebral circulation to achieve acceptable technical success and clinical results.
Disclosures A. Arat: None. E. Daglioglu: None. I. Akmangit: None.