Flow Diversion versus Standard Endovascular Techniques for the Treatment of Unruptured Carotid-Ophthalmic Aneurysms.

Details

Serval ID
serval:BIB_EA24CE3BE5E6
Type
Article: article from journal or magazin.
Collection
Publications
Title
Flow Diversion versus Standard Endovascular Techniques for the Treatment of Unruptured Carotid-Ophthalmic Aneurysms.
Journal
AJNR. American journal of neuroradiology
Author(s)
Di Maria F., Pistocchi S., Clarençon F., Bartolini B., Blanc R., Biondi A., Redjem H., Chiras J., Sourour N., Piotin M.
ISSN
1936-959X (Electronic)
ISSN-L
0195-6108
Publication state
Published
Issued date
12/2015
Peer-reviewed
Oui
Volume
36
Number
12
Pages
2325-2330
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Over the past few years, flow diversion has been increasingly adopted for the treatment of intracranial aneurysms, especially in the paraclinoid and paraophthalmic carotid segment. We compared clinical and angiographic outcomes and complication rates in 2 groups of patients with unruptured carotid-ophthalmic aneurysms treated for 7 years by either standard coil-based techniques or flow diversion.
From February 2006 to December 2013, 162 unruptured carotid-ophthalmic aneurysms were treated endovascularly in 138 patients. Sixty-seven aneurysms were treated by coil-based techniques in 61 patients. Flow diverters were deployed in 95 unruptured aneurysms (77 patients), with additional coiling in 27 patients. Complication rates, clinical outcome, and immediate and long-term angiographic results were retrospectively analyzed.
No procedure-related deaths occurred. Four procedure-related thromboembolic events (6.6%) leading to permanent morbidity in 1 case (1.6%) occurred in the coiling group. Neurologic complications were observed in 6 patients (7.8%) in the flow-diversion group, resulting in 3.9% permanent morbidity. No statistically significant difference was found between complication (P = .9) and morbidity rates (P = .6). In the coiling group (median follow-up, 31.5 ± 24.5 months), recanalization occurred at 1 year in 23/50 (54%) aneurysms and 27/55 aneurysms (50.9%) at the latest follow-up, leading to retreatment in 6 patients (9%). In the flow-diversion group (mean follow-up, 13.5 ± 10.8 months), 85.3% (35/41) of all aneurysms were occluded after 12 months, and 74.6% (50/67) on latest follow-up. The retreatment rate was 2.1%. Occlusion rates between the 2 groups differed significantly at 12 months (P < .001) and at the latest follow-up (P < .005).
Our retrospective analysis shows better long-term occlusion of carotid-ophthalmic aneurysms after use of flow diverters compared with standard coil-based techniques, without significant differences in permanent morbidity.

Keywords
Adult, Aged, Embolization, Therapeutic/instrumentation, Embolization, Therapeutic/methods, Endovascular Procedures/instrumentation, Endovascular Procedures/methods, Female, Humans, Intracranial Aneurysm/diagnostic imaging, Intracranial Aneurysm/therapy, Male, Middle Aged, Radiography, Retreatment, Retrospective Studies, Stents, Treatment Outcome
Pubmed
Create date
03/05/2017 11:44
Last modification date
20/08/2019 16:12
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