RT Journal Article
SR Electronic
T1 Finnish flow diverter study: 8 years of experience in the treatment of acutely ruptured intracranial aneurysms
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 699
OP 703
DO 10.1136/neurintsurg-2021-017641
VO 14
IS 7
A1 Alpay, Kemal
A1 Hinkka, Tero
A1 Lindgren, Antti E
A1 Isokangas, Juha-Matti
A1 Raj, Rahul
A1 Parkkola, Riitta
A1 Sinisalo, Matias
A1 Numminen, Jussi
A1 Pienimäki, Juha-Pekka
A1 Saari, Petri
A1 Seppänen, Janne
A1 Palosaari, Kari
A1 Rautio, Riitta
YR 2022
UL http://jnis.bmj.com/content/14/7/699.abstract
AB Background Flow diversion of acutely ruptured intracranial aneurysms (IAs) is controversial due to high treatment-related complication rates and a lack of supporting evidence. We present clinical and radiological results of the largest series to date.Methods This is a nationwide retrospective study of acutely ruptured IAs treated with flow diverters (FDs). The primary outcome was the modified Rankin Scale (mRS) score at the last available follow-up time. Secondary outcomes were treatment-related complications and the aneurysm occlusion rate.Results 110 patients (64 females; mean age 55.7 years; range 12–82 years) with acutely ruptured IAs were treated with FDs between 2012 and 2020 in five centers. 70 acutely ruptured IAs (64%) were located in anterior circulation, and 47 acutely ruptured IAs (43%) were blister-like. A favorable functional outcome (mRS 0–2) was seen in 73% of patients (74/102). Treatment-related complications were seen in 45% of patients (n=49). Rebleeding was observed in 3 patients (3%). The data from radiological follow-ups were available for 80% of patients (n=88), and complete occlusion was seen in 90% of aneurysms (79/88). The data from clinical follow-ups were available for 93% of patients (n=102). The overall mortality rate was 18% (18/102).Conclusions FD treatment yields high occlusion for acutely ruptured IAs but is associated with a high risk of complications. Considering the high mortality rate of aneurysmal subarachnoid hemorrhage, the prevention of rebleeding is crucial. Thus, FD treatment may be justified as a last resort option.Data are not available for public, however upon a reasonable request it may be provided.