Flow Diverter Stents for the Treatment of Anterior Cerebral Artery Aneurysms: Safety and Effectiveness

Clin Neuroradiol. 2017 Mar;27(1):51-56. doi: 10.1007/s00062-015-0441-8. Epub 2015 Aug 7.

Abstract

Background and purpose: Flow diverter stents (FDSs) are increasingly used for the treatment of intracranial aneurysms. Initially developed for the management of giant and large aneurysms, their indications have progressively expanded. The purpose of our study was to evaluate the safety and effectiveness of FDSs for the treatment of anterior cerebral artery (ACA) aneurysms.

Materials and methods: Among the 94 consecutive patients treated for 100 intracranial aneurysms by means of FDSs in our institution from October 2010 to January 2015, eight aneurysms (8 %) in seven patients were located on the ACA. Three aneurysms were located on the A1 segment, three aneurysms on the anterior communicating artery (ACom) and two on the A2-A3 junction. In three cases, FDS was used for angiographic recurrence after coiling. Five patients were treated with a Pipeline embolization device, one with a NeuroEndograft and the last one with a Silk FDS.

Results: Treatment was feasible in all cases. No technical difficulty was reported. No acute or delayed clinical complication was recorded. Modified Rankin Scale was 0 for six patients and one for one patient. Mean angiographic follow-up was 9.7 ± 3.9 months (range 6-15). Total exclusion was observed in five aneurysms (71.4 %) and neck remnant in two (28.6 %) cases. One patient refused the control DSA.

Conclusion: Our series shows the safety and effectiveness of FDSs for the treatment of ACA aneurysms.

Keywords: A1 segment; Aneurysm; Anterior cerebral artery; Anterior communicating artery; Flow diverter stent; Pericallosal artery.

MeSH terms

  • Blood Vessel Prosthesis / statistics & numerical data*
  • Cerebral Angiography / statistics & numerical data
  • Cerebral Revascularization / instrumentation*
  • Cerebral Revascularization / statistics & numerical data*
  • Female
  • France / epidemiology
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / epidemiology*
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Stents
  • Treatment Outcome