RT Journal Article
SR Electronic
T1 Expanding the use of flow diverters beyond their initial indication: treatment of small unruptured aneurysms
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 245
OP 248
DO 10.1136/neurintsurg-2017-013062
VO 10
IS 3
A1 J M Pumar
A1 A Mosqueira
A1 H Cuellar
A1 B Dieguez
A1 L Guimaraens
A1 J Masso
A1 S Miralbes
A1 M Blanco-Ulla
A1 M Souto-Bayarri
A1 F Vazquez-Herrero
YR 2018
UL http://jnis.bmj.com/content/10/3/245.abstract
AB Background Experience with the endovascular treatment of unruptured small intracranial aneurysms by flow diverter devices is still limited.Objective To assess the safety and efficacy of the SILK flow diverter (SFD) in the treatment of small unruptured cerebral aneurysms (<10 mm).Methods We performed a retrospective review of a prospectively maintained database of patients treated with a SFD between July 2008 and December 2013 at 4 institutions in Spain to identify all patients with small unruptured aneurysms (<10 mm). Data for patient demographics, aneurysm characteristics, and technical procedures were analyzed. Angiographic and clinical findings were recorded during the procedure and at 6- and 12-month follow-ups.Results A total of 109 small aneurysms were treated with a SFD in 104 patients (78 women; 26 men; mean, median, and range of age: 55.2, 57.1, and 19–80 years, respectively). A total of 60 patients were asymptomatic (57.7%). All except 7 aneurysms (6.4%) arose from the anterior circulation. The mean size of the aneurysms was 4.7±1.9 mm. At 6 months, the neuromorbidity and neuromortality rates were 2.9% and 0.9%, respectively. Imaging at the 12-month follow-up showed complete occlusion, neck remnants, and residual aneurysm in 88.5% (69/78), 7.7% (6/78), and 3.3% (3/78) of cases, respectively. No delayed hemorrhage occurred.Conclusions The findings suggest that the indications for SFD can be safely extended to small intracranial aneurysms.