Abstract
Objective
In this study, the authors retrospectively evaluated the effectiveness and the safety
of non-surgical middle cerebral artery (MCA) aneurysms treated via the implantation
of a flow diverter device (FDD).
Methods
Clinical, procedural and follow-up data were analyzed in order to evaluate the safety
and effectiveness of the treatment with the FDD in complex MCA aneurysms. Safety was
assessed recording (intra-procedural, peri-procedural and delayed) complications in
order to determine the morbidity and mortality rates. Functional outcome was evaluated
with modified Rankin Scale (mRS) prior and after the endovascular procedure. To assess
the efficacy, midterm and long-term clinical, angiographic and cross-sectional imaging
follow-ups were recorded.
Results
47 patients (21 males; 26 females) with MCA aneurysms were treated with FDD. 7 were
ruptured. 21 aneurysms were saccular, 19 dissecting, 3 fusiform, 2 blood blister-like
and 2 were pseudo-aneurysms. 14 aneurysms were small, 23 large and 10 giant, with
a mean size of 15.3 mm. 8 aneurysms were recurrent (Raymond-Roy class III): 2 patients
had an aneurysmal sac recanalization after being treated with simple coiling and 6
after being treated with microsurgical clipping. In 4 cases (8.5%), more than one
FDD was telescopically positioned in order to treat the aneurysm, for a total of 54
FDDs used.
The overall mortality rate was 2.1% (1/47) and the overall morbidity rate was 8.6%
(4/47). Midterm neuroimaging follow-ups showed the complete occlusion of the aneurysm
in 63% cases, which became 91% at the end of the follow-up.
Conclusions
FDD is a safe and effective tool that can be used in the treatment of complex MCA
aneurysms, where conventional neurosurgical treatments can be challenging or ineffective.
Keyword
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Article info
Publication history
Published online: October 03, 2022
Accepted:
September 4,
2022
Received in revised form:
August 17,
2022
Received:
July 18,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106760
Copyright
© 2022 Elsevier Inc. All rights reserved.
