Treatment of Intracranial Aneurysms With Flow Diverter Stents Evaluated

July 8, 2015—In Interventional Neuroradiology, Leonardo Giacomini, MD, et al published clinical results of neurovascular reconstruction with flow diverter stents for the treatment of 87 intracranial aneurysms at a single center (2015;21:292–299).

As noted by the investigators in Interventional Neuroradiology, flow diverter stents represent a new endovascular tool to treat complex aneurysms, such as giant, large, wide-necked, and/or fusiform. The highly dense mesh of these stents reduces inflow and outflow inside the aneurysm, resulting in intra-aneurysmal thrombosis and stent endothelialization.

This study is a retrospective review of 77 patients with 87 aneurysms that were treated using two different types of flow diverter stents, the Pipeline embolization device (Medtronic plc) and the Silk flow diverter stent (Balt Extrusion) between October 2010 and September 2013 at an interventional neuroradiology center in São Paulo, Brazil.

The investigators reported that flow diverter stent placement was successful in 98% of the lesions and resulted in an immediate major stasis within most of the treated aneurysms. The overall aneurysm occlusion rate was 80% at 6 months and 84% at 18 months. Symptomatic complications occurred in 11 patients (14.3%) with morbidity in eight (10.4%) and mortality in three (3.9%) patients.

The investigators concluded that flow diversion is a promising technique for treating challenging intracranial aneurysms with acceptable morbidity. A high rate of complete occlusion for small large-necked aneurysms, a low morbidity and mortality rate, and no recanalization encourage their use in these aneurysms. Further studies assessing long-term aneurysm occlusion and recanalization are required, advised the investigators in Interventional Neuroradiology.