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Flow diversion of fusiform intracranial aneurysms.

Publication ,  Journal Article
Griffin, A; Lerner, E; Zuchowski, A; Zomorodi, A; Gonzalez, LF; Hauck, EF
Published in: Neurosurg Rev
June 2021

Fusiform aneurysms are less common than saccular aneurysms, but have higher associated mortality and rebleeding rates. Recently, flow diversion has emerged as a possible treatment option. The purpose of this study was to determine the safety and efficacy of the Pipeline Embolization Device (PED) for the treatment of ruptured and unruptured fusiform aneurysms. This was a retrospective analysis of patients with fusiform intracranial aneurysms treated with a PED at a quaternary care center between January 2012 and September 2019. Occlusion rates, neurologic morbidity/mortality, and other clinical variables were analyzed. Twenty-nine patients with 30 fusiform aneurysms were treated with a PED. Sixteen aneurysms (53%) were located in the anterior circulation and 14 aneurysms (47%) were in the posterior circulation. The mean maximal diameter of the aneurysms was 10.1 ± 5.6 mm (range 2.3-25 mm). Angiographic and clinical follow-up were available for 28 aneurysms (93%). The median follow-up was 17.4 months (IQR 4.8 to 28 months) and occlusion rates were graded according to the O'Kelly-Marotta (OKM) scale. Of patients with DSA follow-up, 15 aneurysms (60%) were completely occluded (OKM D) and 19 aneurysms (76%) had a favorable occlusion result (OKM C1-3 and D). The overall complication rate was 26.7% with a neurological morbidity rate of 6.7% and neurological mortality rate of 3.4%. Flow diversion can be an effective treatment for both ruptured and unruptured fusiform aneurysms. Nevertheless, complete occlusion rates are lower than for saccular aneurysms. Therefore, flow diversion should be considered only if other more direct treatment options, such as clipping or stent/coiling are not applicable. Flow diversion should be used cautiously in patients presenting with rupture.

Duke Scholars

Published In

Neurosurg Rev

DOI

EISSN

1437-2320

Publication Date

June 2021

Volume

44

Issue

3

Start / End Page

1471 / 1478

Location

Germany

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Self Expandable Metallic Stents
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans
  • Follow-Up Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Griffin, A., Lerner, E., Zuchowski, A., Zomorodi, A., Gonzalez, L. F., & Hauck, E. F. (2021). Flow diversion of fusiform intracranial aneurysms. Neurosurg Rev, 44(3), 1471–1478. https://doi.org/10.1007/s10143-020-01332-0
Griffin, Andrew, Emily Lerner, Adam Zuchowski, Ali Zomorodi, L Fernando Gonzalez, and Erik F. Hauck. “Flow diversion of fusiform intracranial aneurysms.Neurosurg Rev 44, no. 3 (June 2021): 1471–78. https://doi.org/10.1007/s10143-020-01332-0.
Griffin A, Lerner E, Zuchowski A, Zomorodi A, Gonzalez LF, Hauck EF. Flow diversion of fusiform intracranial aneurysms. Neurosurg Rev. 2021 Jun;44(3):1471–8.
Griffin, Andrew, et al. “Flow diversion of fusiform intracranial aneurysms.Neurosurg Rev, vol. 44, no. 3, June 2021, pp. 1471–78. Pubmed, doi:10.1007/s10143-020-01332-0.
Griffin A, Lerner E, Zuchowski A, Zomorodi A, Gonzalez LF, Hauck EF. Flow diversion of fusiform intracranial aneurysms. Neurosurg Rev. 2021 Jun;44(3):1471–1478.
Journal cover image

Published In

Neurosurg Rev

DOI

EISSN

1437-2320

Publication Date

June 2021

Volume

44

Issue

3

Start / End Page

1471 / 1478

Location

Germany

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Self Expandable Metallic Stents
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans
  • Follow-Up Studies