Italian Multicenter Experience With Flow-Diverter Devices for Intracranial Unruptured Aneurysm Treatment With Periprocedural Complications--A Retrospective Data Analysis

Neuroradiology. 2012 Oct;54(10):1145-52. doi: 10.1007/s00234-012-1047-3. Epub 2012 May 9.

Abstract

Introduction: We report the experiences of 25 Italian centers, analyzing intra- and periprocedural complications of endovascular treatment of intracranial aneurysms using Silk (Balt Extrusion, Montmorency, France) and pipeline embolization devices (EV3 Inc, Irvine California).

Methods: Two hundred seventy-three patients with 295 cerebral aneurysms, enrolled in 25 centers in Italy and treated with the new flow-diverter devices, were evaluated; 142 patients were treated with Silk and 130 with pipeline (in one case, both devices were used). In 14 (5.2 %) cases devices were used with coils. Aneurysm size was >15 mm in 46.9 %, 5-15 mm in 42.2 %, and <5 mm in 10.8 %. Aneurysm locations were supraclinoid internal carotid artery (ICA) in 163 cases (55.2 %), cavernous ICA in 76 (25.7 %), middle cerebral artery in 11 (3.7 %), PCoA in 6 (2 %), and ACoA in 2 (0.7 %); the vertebrobasilar system accounted for 32 cases (10.8 %) and PCA in 5 (1.7 %).

Results: Technical adverse events occurred with 59 patients (21.6 %); 5 patients died after ischemic events, 10 to hemorrhagic complications, and 1 from external ventricular drain positioning. At 1 month, morbidity and mortality rates were 3.7 % and 5.9 %, respectively

Conclusion: Our retrospective study confirms that morbidity and mortality rates in treatment with FDD of unruptured wide-neck or untreatable cerebral aneurysms do not differ from those reported in the largest series.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aneurysm, Ruptured / mortality
  • Aneurysm, Ruptured / surgery
  • Blood Vessel Prosthesis / statistics & numerical data*
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Intracranial Aneurysm / mortality*
  • Intracranial Aneurysm / surgery*
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Postoperative Complications / mortality*
  • Retrospective Studies
  • Risk Factors
  • Stents / statistics & numerical data*
  • Survival Analysis
  • Survival Rate
  • Treatment Outcome