Long-term results of flow diversion in the treatment of intracranial aneurysms: a retrospective data analysis of a single center

• Published in: Acta neurochirurgica 2019-06, Vol.161 (6), p.1165-1173
• Main Authors: Korkmazer, Bora, Kocak, Burak, Islak, Civan, Kocer, Naci, Kizilkilic, Osman
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aneurysm; Aneurysms; Angiography; Cardiovascular system; Child; Diversion; Diverters; Endovascular Procedures - adverse effects; Endovascular Procedures - methods; Female; Humans; Implants; Interventional Radiology; Intracranial Aneurysm - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Morbidity; Mortality; Neurology; Neuroradiology; Neurosurgery; Occlusion; Original Article - Vascular Neurosurgery - Aneurysm; Patients; Postoperative Complications - diagnostic imaging; Postoperative Complications - epidemiology; Stents - adverse effects; Surgical Orthopedics; Treatment Outcome; Vascular Neurosurgery – Aneurysm
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-019-03912-6

Purpose Endovascular techniques are frequently used for the treatment of intracranial aneurysms and flow diverter stents are relatively new and important devices in this field. The aim of our study is to report long-term follow-up results of flow diversion treatment. Methods We retrospectively examined angiographic images and clinical reports of 133 patients (female, 112 [84%]; mean age, 46.3 years [range, 12–70 years]) who were treated with flow diverters between 2008 and 2013 and were followed up radiologically at least 1 year. The aneurysms treated with flow diverters were assessed according to technical problems, stent patency, residual filling, re-growth, and occlusion status, and the patients were assessed according to morbidity and mortality. Results Except for ten patients, one aneurysm was treated per patient. Median duration of the follow-up was 927 days. Total occlusion rates in angiographic follow-up were found 76.2% for the sixth-month, 86.7% for the first-year, 93.6% for the third-year, 94.2% for the fifth-year, and 90.2% for entire follow-up period. Nine stent morphology changes were observed in the angiographic controls. Overall mortality and morbidity rates were 3.7% and 4.3%, respectively. Conclusion Despite technical difficulties and delayed hemorrhages, flow diverter stents are effective tools for the treatment of challenging aneurysms in the long run. Nonetheless, long-term results of flow diversion treatment must be evaluated hemodynamically and clinically in multicenter studies.