Publication:
Safety and efficacy of flow diverter stents in the treatment of middle cerebral artery aneurysms: a single-center experience and follow-up data

dc.contributor.coauthorSoydemir, Efe
dc.contributor.coauthorTüreli, Derya
dc.contributor.coauthorBaltacıoğlu, Nurten Andaç
dc.contributor.coauthorBayri, Yaşar
dc.contributor.coauthorBaltacıoğlu, Feyyaz
dc.contributor.kuauthorGündoğmuş, Cemal Aydin
dc.contributor.kuprofileDoctor
dc.contributor.schoolcollegeinstituteN/A
dc.contributor.unitKoç University Hospital
dc.contributor.yokidN/A
dc.date.accessioned2024-11-09T23:02:41Z
dc.date.issued2023
dc.description.abstractPURPOSE: This study aims to evaluate the safety and efficacy of flow diverters (FDs) in the treatment of middle cerebral artery (MCA) aneurysms and share the follow-up (F/U) results. METHODS: The treatment and F/U results of 76 MCA aneurysms treated with the flow re-direction endoluminal device (FRED), FRED Jr., and pipeline embolization device (PED) FD stents were evaluated retrospectively. The aneurysm occlusion rates were compared between FDs, and the integrated and jailed branches were evaluated through follow-ups. The oversizing of the stent was compared between occluded/non-occluded aneurysms and integrated branches. RESULTS: The mean F/U duration was 32 ± 6.3 months, and the mean aneurysm diameter was 4.45 mm. A total of 61 (80.3%) aneurysms were wide-necked; 73 (96.1%) were saccular; 52 (68.4%) were located at the M1 segment; and 36 (45.6%) FREDs, 23 (29.1%) FRED Jr.s, and 19 (24.1%) PEDs were used for treatment. The overall occlusion rates for the 6-, 12-, 24-, 36-, and 60-month digital subtraction angiographies were 43.8%, 63.5%, 73.3%, 85.7%, and 87.5% respectively. The last F/U occlusion rates were 67.6% for FRED, 66.7% for PED, and 60.6% for FRED Jr. (P = 0.863). An integrated branch was covered with an FD during the treatment of 63 (82.8%) aneurysms. A total of six (10%) of the integrated branches were occluded without any symptoms at the last F/U appointment. The median oversizing was 0.45 (0-1.30) for occluded aneurysms, and 0.50 (0-1.40) for non-occluded aneurysms (P = 0.323). The median oversizing was 0.70 (0.45-1.10) in occluded integrated branches and 0.50 (0-1.40) in non-occluded branches (P = 0.131). In-stent stenosis was seen in 22 (30.1%) of the stents at the 6-month F/U and in only 2 (4.7%) at the 24-month F/U. Thus, none of the patients had any neurological deficits because of the in-stent stenosis. Severe in-stent stenosis was seen in two stents. CONCLUSION: MCA aneurysms tend to be complex, with integrated branches and potentially wide necks. FD stents are safe and effective in the treatment of MCA aneurysms, and the patency of the side and jailed branches is preserved in most cases. Higher occlusion and lower in-stent stenosis rates are seen with longer F/U durations.
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.indexedbyWoS
dc.description.indexedbyTR Dizin
dc.description.issue2
dc.description.openaccessYES
dc.description.publisherscopeNational
dc.description.volume29
dc.identifier.doi10.4274/dir.2022.211050
dc.identifier.issn1305-3612
dc.identifier.linkhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85151113742&doi=10.4274%2fdir.2022.211050&partnerID=40&md5=b585fcf1562bb76998bc0908d3193421
dc.identifier.scopus2-s2.0-85151113742
dc.identifier.urihttp://dx.doi.org/10.4274/dir.2022.211050
dc.identifier.urihttps://hdl.handle.net/20.500.14288/8342
dc.identifier.wos1038761200006
dc.keywordsAneurysm
dc.keywordsFlow diverter
dc.keywordsFRED
dc.keywordsMCA
dc.keywordsPipeline cerebral angiography
dc.keywordsConstriction, Pathologic
dc.keywordsEmbolization, Therapeutic
dc.keywordsEndovascular procedures
dc.keywordsFollow-up studies
dc.keywordsHumans
dc.keywordsIntracranial aneurysm
dc.keywordsRetrospective studies
dc.keywordsStents
dc.keywordsTreatment outcome
dc.keywordsVascular diseases
dc.keywordsArtificial embolization
dc.keywordsBrain angiography
dc.keywordsDiagnostic imaging
dc.keywordsEndovascular surgery
dc.keywordsFollow up
dc.keywordsHuman
dc.keywordsIntracranial aneurysm
dc.keywordsProcedures
dc.keywordsRetrospective study
dc.keywordsStenosis, Occlusion and obstruction
dc.keywordsStent
dc.keywordsTreatment outcome
dc.keywordsVascular disease
dc.languageEnglish
dc.publisherTurkish Society of Radiology
dc.sourceDiagnostic and interventional radiology (Ankara, Turkey)
dc.subjectArtificial embolization
dc.subjectDiverters
dc.subjectStents
dc.titleSafety and efficacy of flow diverter stents in the treatment of middle cerebral artery aneurysms: a single-center experience and follow-up data
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.authoridN/A
local.contributor.kuauthorGündoğmuş, Cemal Aydin

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