Flow-diverting stents for the treatment of unruptured distal anterior cerebral artery aneurysms: analysis of the CRETA Registry

被引:0
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作者
Scarcia, Luca [1 ]
Clarencon, Frederic [2 ,3 ]
Dmytriw, Adam A. [4 ,5 ,6 ]
Shotar, Eimad [2 ]
Premat, Kevin [2 ]
Jabbour, Pascal [7 ]
Tjoumakaris, Stavropoula, I [7 ]
Gooch, Reid [7 ]
Psychogios, Marios-Nikos [8 ]
Ntoulias, Nikolaos [8 ]
Sporns, Peter B. [9 ]
Puri, Ajit S. [10 ]
Singh, Jasmeet [10 ]
Kuhn, Anna Luisa [10 ]
Hassan, Ameer E. [11 ]
Algin, Oktay [12 ]
Moehlenbruch, Markus A. [13 ]
Hohenstatt, Sophia [13 ]
Russo, Riccardo [14 ]
Bergui, Mauro [14 ]
Goren, Oded [15 ]
Kole, Matthew J. [15 ]
Bankole, Nourou Dine Adeniran [16 ]
Bibi, Richard [16 ]
Boulouis, Gregoire [16 ]
Morimoto, Takeshi [17 ]
Sakakibara, Fumihiro [17 ]
Pop, Raoul [18 ]
Juravle, Ciprian [18 ]
Ho, Joanna W. K. [19 ]
Ferrario, Angel [20 ]
Pujol Lereis, Virginia [21 ]
Cooper, Jared [22 ]
Gandhi, Chirag D. [22 ]
Salsano, Giancarlo [23 ]
Castellan, Lucio [23 ]
Camilli, Arianna [24 ]
Consoli, Arturo [25 ,26 ]
Sgreccia, Alessandro [25 ]
Raz, Eytan [27 ]
Chung, Charlotte [27 ]
Burel, Julien [28 ]
Papagiannaki, Chrysanthi [28 ]
Rasheed, Umair [29 ]
Baqir Hassan, Khawaja Muhammad [29 ]
Hong, Tao [30 ]
Ji, Zhe [30 ]
Rautio, Riitta [31 ]
Sinislao, Matias [31 ]
Ruggiero, Maria [32 ]
机构
[1] Henri Mondor Hosp, Neuroradiol, Creteil, France
[2] Sorbonne Univ, La Pitie Salpetriere Hosp, APHP, Dept Neuroradiol, 47 Bd Hop, F-75013 Paris, France
[3] Sorbonne Univ, Paris, France
[4] Harvard Univ, Massachusetts Gen Hosp, Neuroendovasc Program, Boston, MA USA
[5] Harvard Univ, Brigham & Womens Hosp, Boston, MA USA
[6] Univ Toronto, St Michaels Hosp, Div Diagnost & Therapeut Neuroradiol, Toronto, ON, Canada
[7] Thomas Jefferson Univ Hosp, Dept Neurosurg, Philadelphia, PA 19107 USA
[8] Univ Spital Basel, Diagnost & Intervent Neuroradiol Dept, Basel, Switzerland
[9] Stadtspital, Dept Radiol & Neuroradiol, Zurich, Switzerland
[10] Univ Massachusetts, Med Ctr, Dept Radiol, Div Neurointervent Radiol, Worcester, MA USA
[11] Univ Texas Rio Grande Valley, Valley Baptist Med Ctr, Dept Neurol, Harlingen, TX 78550 USA
[12] Ankara Univ, Dept Radiol, Ankara, Turkiye
[13] Heidelberg Univ Hosp, Dept Neuroradiol, Heidelberg, Germany
[14] Univ Turin, Dept Neurosci, Neuroradiol Unit, Azienda Osped Univ Citta Salute & Sci Torino, Turin, Italy
[15] Geisinger Hlth Syst, Dept Neurosurg, Danville, PA USA
[16] Teaching Hosp Tours, INSERM, Clin Invest Ctr CIC 1415, Dept Intervent Neuroradiol, Tours, France
[17] Hyogo Med Univ, Dept Data Sci, Nishinomiya, Hyogo, Japan
[18] Strasbourg Univ Hosp, Intervent Neuroradiol, Strasbourg, France
[19] Kwong Wah Hosp, Dept Neurosurg, Hong Kong, Peoples R China
[20] FLENI, Dept Neurocirugia, Serv Neurorradiol Intervencionista, Buenos Aires, Argentina
[21] FLENI, Inst Neurol Res, Dept Neurol, Vasc Neurol Div, Buenos Aires, DF, Argentina
[22] Westchester Med Ctr, Dept Neurosurg, Valhalla, NY USA
[23] IRCCS Osped Policlin San Martino, UO Neuroradiol, Genoa, Italy
[24] Univ Cattolica Sacro Cuore, Rome, Italy
[25] Foch Hosp, Diagnost & Intervent Neuroradiol Dept, Suresnes, France
[26] Univ Versailles, Yvelines, France
[27] NYU Langone Hlth, Dept Neurosurg, New York, NY USA
[28] Rouen Univ Hosp, Dept Rheumatol, Rouen, Normandy, France
[29] Lahore Gen Hosp, Dept Neuroradiol, Lahore, Pakistan
[30] Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China
[31] Turku Univ Hosp, Dept Intervent Radiol, Turku, Finland
[32] AUSL Romagna, Dermatol Unit, Ravenna, Italy
[33] Univ Roma Tor Vergata, Dept Biomed & Prevent, Rome, Italy
[34] Univ Padua, Padua, Italy
[35] Univ Washington, Dept Neurol Surg, Seattle, WA USA
[36] Univ Messina, Neuroradiol Unit, Biomed Sci & Morphol & Funct Images, Messina, Italy
[37] CHU Toulouse, Serv Neuroradiol Intervent & Diagnost, Serv Hepatogastroenterol, Hop Purpan, Toulouse, France
[38] Bordeaux Univ Hosp, Neuroradiol Dept, Bordeaux, France
[39] Careggi Univ Hosp, Intervent Neuroradiol Unit, I-50134 Florence, Italy
[40] ASST Grande Osped Metropolitano Niguarda, Reumatol Unit, Milan, Italy
[41] Hop Lariboisiere, AP HP Nord, Dept Neuroradiol, F-75010 Paris, France
[42] Fdn IRCCS Policlin San Matteo, Neuroradiol Unit, I-27100 Pavia, Italy
[43] Univ Hosp Ctr Besancon, Dept Intervent Neuroradiol, Besancon, France
[44] NAMS Ukraine, Res & Pract Ctr Endovascular Neuroradiol, Kiev, Ukraine
[45] Erasme Univ Hosp, Dept Intervent Neuroradiol, B-1070 Brussels, Belgium
[46] Fdn Policlin Univ Agostino Gemelli IRCCS Roma, Rome, Italy
关键词
Aneurysm; Flow Diverter; Angiography; PIPELINE EMBOLIZATION DEVICE; ENDOVASCULAR TREATMENT; SAFETY; EFFICACY; VESSELS;
D O I
10.1136/jnis-2024-022315
中图分类号
R445 [影像诊断学];
学科分类号
100207 ;
摘要
Background Data about the safety and the efficacy of flow diversion for distal anterior cerebral artery (DACA) aneurysms are limited. We present the largest multicenter analysis evaluating the outcomes of flow diversion in unruptured DACA aneurysm treatment.Methods Databases from 39 centers were retrospectively reviewed for unruptured DACA aneurysms treated with flow-diverting stents. Demographics, clinical presentation, radiographic characteristics, procedural complications, and outcomes were assessed.Results A total of 168 patients with 168 unruptured DACA aneurysms were treated between January 2018 and December 2022. One hundred and twenty-five were women (74.4%) and the median age was 61 (IQR 52-67) years. The most common morphology was saccular (91.7%), with branch involvement in 61.9% of cases. Median parent vessel diameter was 1.9 mm (IQR 1.7-2.2) and stents were successfully deployed in 99.4% of cases. In 96.4% a single stent was implanted, while 3.6% of cases required two stents. Median imaging follow-up was 16.5 (IQR 7-24) months. At last follow-up the rate of occlusion (O'Kelly-Marotta scale C or D) was 82.1%. Symptomatic thromboembolic or hemorrhagic complications occurred in 5.3% of patients and the mortality rate was 0.6%. The rate of retreatment was 1.2%.Conclusions Flow-diverting stents are a reasonably safe and effective treatment option for unruptured DACA aneurysms.
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页数:7
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