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Review ArticleInterventional
Open Access

Flow Diversion in the Treatment of Intracranial Aneurysms: A Pragmatic Randomized Care Trial

J. Raymond, D. Iancu, W. Boisseau, J.D.B. Diestro, R. Klink, M. Chagnon, J. Zehr, B. Drake, H. Lesiuk, A. Weill, D. Roy, M.W. Bojanowski, C. Chaalala, J.L. Rempel, C. O’Kelly, M.M. Chow, S. Bracard and T.E. Darsaut
American Journal of Neuroradiology September 2022, 43 (9) 1244-1251; DOI: https://doi.org/10.3174/ajnr.A7597

Article Figures & Data

Figures

Tables

  • Table 1:

    Patient and aneurysm characteristics for the randomized groups

    CharacteristicsRandomization
    ASMO (n = 139)FD (n = 139)
    Age (mean) (SD)57 (12)58 (12)
    Female (No.) (%)108 (77.7%)110 (79.1%)
    Presentation (No.) (%)  
     Asymptomatic72 (51.8%)78 (56.1%)
     Mass effect41 (29.5%)40 (28.8%)
     SAH26 (18.7%)21 (15.1%)
    Aneurysm size (mm)  
     Mean (SD)13 (9)13 (10)
     Median (range)10 (2–51)10 (1–56)
      0–9 (No.) (%)66 (47.5%)68 (48.9%)
      10–25 (No.) (%)59 (42.4%)54 (38.8%)
      >25 (No.) (%)14 (10.1%)17 (12.2%)
    Aneurysm neck (mm)  
     Mean (SD)5 (3)5 (3)
     Median (min–max)5 (2–15)5 (1–16)
     Undefined (No.) (%)22 (15.8%)21 (15.1%)
    Location (No.) (%)  
     Anterior circulation108 (77.7%)109 (78.4%)
      Proximal carotid71 (51.1%)74 (53.2%)
       Extradural14 (10.1%)21 (15.1%)
       Ophthalmic57 (41.0%)53 (38.1%)
      Other carotid20 (14.4%)12 (8.6%)
      Other anterior17 (12.2%)23 (16.5%)
     Posterior circulation31 (22.3%)30 (21.6%)

    • Note:—min indicates minimum; max. maximum.

  • Table 2:

    Primary efficacy outcome

    Randomization
    ASMO (n = 139) (No.) (%)FD (n = 139) (No.) (%)
    Poor outcome62 (44.6%)a43 (30.9%)
    Clinical13 (9.4%)12 (8.6%)
     mRS >2b13 (9.4%)10 (7.2%)
     Aneurysm rupture02 (1.4%)
    Angiographic49 (35.3%)31 (22.3%)
     Retreatment7 (5.0%)5 (3·6%)
     Immediate failurec8 (5.8%)7 (5.0%)
     Residual aneurysm34 (24.5%)19 (13.7%)
    Good outcome74 (53.2%)96 (69.1%)
    Angiographic74 (53.2%)96 (69.1%)
     Complete occlusion60 (43.2%)85 (61.2%)
     Residual neck14 (10.1%)11 (7.9%)
    Not available3 (2.2%)0

    • a It is 45.6% (62/136) when adjusting for missing data.

    • ↵b Comprises 14 deaths (ASMO = 9/FD = 5).

    • ↵c Immediate treatment failures are treatments that were attempted but failed, with no further angiographic follow-up.

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Flow Diversion for Intracranial Aneurysms: A Trial
J. Raymond, D. Iancu, W. Boisseau, J.D.B. Diestro, R. Klink, M. Chagnon, J. Zehr, B. Drake, H. Lesiuk, A. Weill, D. Roy, M.W. Bojanowski, C. Chaalala, J.L. Rempel, C. O’Kelly, M.M. Chow, S. Bracard, T.E. Darsaut
American Journal of Neuroradiology Sep 2022, 43 (9) 1244-1251; DOI: 10.3174/ajnr.A7597
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