Flow diverter stents for unruptured saccular anterior circulation perforating artery aneurysms: safety, efficacy, and short-term follow-up
Authors
Kuhn, Anna L.Hou, Samuel Y.
Perras, Mary
Brooks, Christopher
Gounis, Matthew J.
Wakhloo, Ajay K.
Puri, Ajit S.
UMass Chan Affiliations
New England Center for Stroke ResearchDepartment of Radiology, Division of Neuroimaging and Intervention
Document Type
Journal ArticlePublication Date
2014-07-21
Metadata
Show full item recordAbstract
BACKGROUND: Anterior circulation perforating artery aneurysms including anterior choroidal artery and lenticulostriate artery aneurysms are rare. Injury to these vessels can lead to severe debilitating symptoms. OBJECTIVE: To present a new approach to treatment using flow diversion technology. METHODS: Patients treated with a Pipeline embolization device (PED) for perforator artery aneurysms at our institution between June 2012 and May 2013 were identified and included in our retrospective analysis. We evaluated patient vascular risk factors; family history of aneurysms; aneurysm characteristics; National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) on admission; and angiography follow-up and patient clinical outcome at discharge, 6 months, and 1 year. RESULTS: We included four patients with a mean age of 59.8 years. Two patients had a positive family history of aneurysms. Patient vascular risk factors included smoking, dyslipidemia, and hypertension. All patients presented with a NIHSS and mRS of 0 on admission. Aneurysms were located at the anterior choroidal (n=2) or lenticulostriate artery (n=2) and were treated with a single PED. No periprocedural or postprocedural complications occurred. The patients were discharged with no change in NHISS or mRS score. Six-month and 1-year follow-up angiography showed complete aneurysm occlusion. Mild intimal hyperplasia was seen in 2 cases at 6 months, but was resolved at the 1-year follow-up. No re-treatment was necessary. NIHSS and mRS remained 0 at follow-up time points. CONCLUSIONS: Our preliminary results show that flow diversion technology is an effective and safe therapy for complex, hard-to-treat aneurysms in perforating arteries. Larger studies with long-term follow-up are needed to validate our promising results.Source
J Neurointerv Surg. 2014 Jul 21. pii: neurintsurg-2014-011237. doi: 10.1136/neurintsurg-2014-011237. Link to article on publisher's site.DOI
10.1136/neurintsurg-2014-011237Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48020PubMed ID
25051964Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1136/neurintsurg-2014-011237