Fellows’ Journal Club
Editor’s Comment
Fourteen patients with 15 saccular, nondissecting MCA bifurcation aneurysms were treated with flow-diverter stents and were retrospectively analyzed. Procedure-related morbidity and mortality at last follow-up were 21% and 0%, respectively. Complete occlusion was achieved in 62%. The authors conclude that compared with other therapeutic options, flow-diverter stents do not appear to be suitable for the treatment of saccular MCA bifurcation aneurysms.
Abstract
BACKGROUND AND PURPOSE
The flow-diverter stent has been proved a feasible, safe, and efficient technique, particularly for the treatment of large and broad-neck carotid siphon aneurysms. Wide-neck bifurcation aneurysms remain, in some cases, a challenge for neurointerventionalists. We report the outcomes of the treatment of saccular middle cerebral artery bifurcation aneurysms with flow diversion in our institution.
MATERIALS AND METHODS
From the institution data base, all saccular, nondissecting MCA bifurcation aneurysms, treated with flow-diverter stents, were retrospectively reviewed. Technical issues, immediate posttreatment and follow-up angiographic findings, and clinical outcomes were assessed.
RESULTS
Fourteen patients with 15 aneurysms were included in the study. Ischemic complications, as confirmed by MR imaging, occurred in 6 patients (43%). Procedure-related morbidity and mortality at last follow-up were 21% and 0%, respectively. Angiographic follow-up was available for 13 aneurysms, with a mean follow-up of 16 months. Complete occlusion was obtained for 8 aneurysms (62%).
CONCLUSIONS
Compared with other available therapeutic options, the flow-diverter stent does not appear to be a suitable solution for the treatment of saccular MCA bifurcation aneurysms.
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