Behandlung zerebraler Aneurysmen mit Stents hoher Maschendichte - mittelfristige Ergebnisse und Follow-up

Abstract

Flow diverters (FDs) are designed for the endovascular treatment of complex intracranial aneurysm confgurations. From February 2009 to March 2013 28 patients (22 females, 6 males) were treated with FD; mean age was 57 years. Data, including aneurysm features, clinical presentation, history of previous bleeding, treatment, and follow-up results, are presented. Early postinterventional neurological de cits (transient: 𝑛�������� = 3/enduring: 𝑛�������� = 1) appeared in 4/28 patients (14%), and early improvement of neurological symptoms was observed in 7 patients with previous restriction of cranial nerve function. e overall occlusion rate was 20/26 (77%; 59% a er 3 months). 77% achieved best results according to O’Kelly-Marotta score grade D with no contrast material lling (70% of those a er 3 months). In 4/6 patients who did not achieve grade D, proximal and/or distal stent overlapping ≥5 mm was not guaranteed su ciently. During follow-up we did not detect any aneurysm recurrence or haemorrhage. In-stent stenosis emerged as the most frequent complication (4/27; 15%) followed by 2 cases of vascular obliteration (AICA/VA). In conclusion endovascular reconstruction using a FD represents a modern and e ective treatment in those aneurysms that are not suitable for conventional interventional or surgical treatment. e appearance of severe complications was rare.