Flow Diversion Therapy of Remnant and Recurrent Intracranial Aneurysms Treated Surgically


Akgül E., Onan H. B., Can Y., Ertan G., Erol C., Çetinkal A., ...More

TURKISH NEUROSURGERY, vol.33, no.4, pp.601-609, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 33 Issue: 4
  • Publication Date: 2023
  • Doi Number: 10.5137/1019-5149.jtn.41653-22.2
  • Journal Name: TURKISH NEUROSURGERY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE
  • Page Numbers: pp.601-609
  • Keywords: Flow diverter stent, Cerebral aneurysm, Recurrent aneurysm, Remnant aneurysm, Surgical treatment
  • Istanbul Medipol University Affiliated: Yes

Abstract

AIM: To evaluate the safety and efficacy of flow diverter stents (FDSs) for treating remnant or recurrent intracranial aneurysms that were treated surgically. MATERIAL AND METHODS: The patients who were treated with FDSs due to remnant or recurrent intracranial aneurysms after microsurgery were included in the study. The patients' demographics, treatment histories, aneurysm features, complications associated with flow diversion, and neurological and angiographic follow-up findings were evaluated. RESULTS: Twenty patients (eight males) with 20 aneurysms were included in the study. Of 20 aneurysms, 18 (90%) were in the anterior, and two (10%) were in the posterior circulation. The initial treatment methods were clipping in 17 (85%) and wrapping in three (15%) aneurysms. The endovascular procedure was successful in all patients. In three patients (15%), periprocedural and postprocedural complications were encountered. No hemorrhagic complications were detected on cone-beam computed tomography. One patient with a basilary aneurysm died because of brain stem ischemia. The total morbimortality was 5%. The mean length of follow-up was 13.7 ± 7.3 months in 18 patients. The first angiographic follow-up (3-6 months) revealed the complete occlusion in 7 of 11 aneurysms (63.6%). By contrast, 16 aneurysms (94.1%) were occluded at the last angiographic follow-up, one aneurysm (5.9%) was still filling. CONCLUSION: An FDS seems effective, safe, and extremely attractive in treating remnant and recurrent intracranial aneurysms treated surgically.