TY - JOUR
T1 - Current trends and results of endovascular treatment of unruptured intracranial aneurysms at a single institution in the flow-diverter era
AU - Petr, O.
AU - Brinjikji, W.
AU - Cloft, H.
AU - Kallmes, D. F.
AU - Lanzino, G.
PY - 2016/6
Y1 - 2016/6
N2 - BACKGROUND AND PURPOSE: During the past several years, the number of unruptured aneurysms treated with endovascular techniques has increased. Traditionally, coil embolization was the treatment of choice for these lesions; however, recently flow diversion has become a viable, and in some cases superior, treatment option. The current single-center study presents results and trends of endovascular treatment with flow diversion and coil embolization in an unselected group of patients with unruptured intracranial aneurysms in a "real world" setting during the flow-diverter era. MATERIALS AND METHODS: Three hundred ten patients with 318 treated unruptured aneurysms from June 2009 to May 2015 were included. Patient demographics, clinical characteristics, aneurysm/treatment characteristics, and outcomes were collected prospectively. We studied the following: intensive care unit admission/reasons, perioperative and mid-/long-term complications, target aneurysm rupture, retreatment/recurrence rates, and long-term neurologic outcome using the mRS. RESULTS: The flow-diverter group had a larger mean aneurysm size (12.3 ± 8.6 mm versus 8.7 ± 6.3 mm, P < .0001). There were no significant differences in the immediate (P = .43) and mid-/long-term complication rates (P = .54) between groups. Periprocedural neurologic morbidity and mortality rates were 2.1% and 0.5% in the coiling group and 2.5% and 1.6% in the flow-diverter group. Patients with coiling were more likely to be retreated than those with flow diversion (14.8% versus 5.7%, P = .009). Worsening of the mRS due to the target aneurysm was noted in only 3.2% of patients. CONCLUSIONS: The endovascular treatment of unruptured aneurysms can be performed with very low rates of neurologic complications. Both flow-diverter and coil therapy were safe and effective.
AB - BACKGROUND AND PURPOSE: During the past several years, the number of unruptured aneurysms treated with endovascular techniques has increased. Traditionally, coil embolization was the treatment of choice for these lesions; however, recently flow diversion has become a viable, and in some cases superior, treatment option. The current single-center study presents results and trends of endovascular treatment with flow diversion and coil embolization in an unselected group of patients with unruptured intracranial aneurysms in a "real world" setting during the flow-diverter era. MATERIALS AND METHODS: Three hundred ten patients with 318 treated unruptured aneurysms from June 2009 to May 2015 were included. Patient demographics, clinical characteristics, aneurysm/treatment characteristics, and outcomes were collected prospectively. We studied the following: intensive care unit admission/reasons, perioperative and mid-/long-term complications, target aneurysm rupture, retreatment/recurrence rates, and long-term neurologic outcome using the mRS. RESULTS: The flow-diverter group had a larger mean aneurysm size (12.3 ± 8.6 mm versus 8.7 ± 6.3 mm, P < .0001). There were no significant differences in the immediate (P = .43) and mid-/long-term complication rates (P = .54) between groups. Periprocedural neurologic morbidity and mortality rates were 2.1% and 0.5% in the coiling group and 2.5% and 1.6% in the flow-diverter group. Patients with coiling were more likely to be retreated than those with flow diversion (14.8% versus 5.7%, P = .009). Worsening of the mRS due to the target aneurysm was noted in only 3.2% of patients. CONCLUSIONS: The endovascular treatment of unruptured aneurysms can be performed with very low rates of neurologic complications. Both flow-diverter and coil therapy were safe and effective.
UR - http://www.scopus.com/inward/record.url?scp=84974623951&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84974623951&partnerID=8YFLogxK
U2 - 10.3174/ajnr.A4699
DO - 10.3174/ajnr.A4699
M3 - Article
C2 - 26797138
AN - SCOPUS:84974623951
SN - 0195-6108
VL - 37
SP - 1106
EP - 1113
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 6
ER -