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Retreatment strategies for recurrent and residual aneurysms after treatment with flow-diverter devices

  • Interventional Neuroradiology
  • Published:
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Abstract

Purpose

The management of residual or persistent intracranial aneurysms after flow-diversion therapy is not well defined in the literature. In this multicentric study, we report clinical and angiographic outcomes of 11 patients that underwent retreatment for 12 aneurysms initially treated with flow-diverter stents.

Methods

The median patient age was 53 years. Aneurysms (median size, 7.3 mm) were located at the internal carotid artery in 9 cases, and at the posterior circulation in 3. Treatment strategies, complications, and angiographic outcome were retrospectively assessed.

Results

Retreatment was feasible in all cases and performed by overlapping flow-diverter implantation. Overall, 12 side vessels were covered during retreatment, whereof 10 (83.3%) remained patent until mid-term follow-up. There were no further technical or symptomatic complications and no treatment-related morbidity. Angiographic follow-up (median, 17 months) showed improved aneurysm occlusion in all patients. Complete or near-complete aneurysm occlusion was achieved in 11 aneurysms (91.7%).

Conclusion

Required retreatment after failed flow-diversion therapy can be performed with adequate safety and efficacy by placement of additional flow-diverter stents.

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Funding

No funding was received for this study.

Author information

Author notes

  1. CK and FD contributed equally to this work.

Authors and Affiliations

  1. Department of Neuroradiology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany

    Lukas Goertz, Nuran Abdullayev & Christoph Kabbasch

  2. Center for Neurosurgery, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany

    Lukas Goertz & Boris Krischek

  3. Department of Radiology, LMU University Hospital of Munich, Munich, Germany

    Nina Hesse

  4. Department of Neuroradiology, LMU University Hospital of Munich, Munich, Germany

    Thomas Liebig & Franziska Dorn

  5. Department of Vascular and Endovascular Surgery, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany

    Wael Ahmad

Authors
  1. Lukas Goertz
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  2. Nina Hesse
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  3. Thomas Liebig
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  4. Wael Ahmad
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Contributions

LG, NH, TL, WA, NA, and BK acquired the data. LG, CK, and FD developed the project, analyzed the data, and drafted the manuscript. All authors revised the paper critically for important intellectual content and provided final approval of the version published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Lukas Goertz.

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Conflict of interest

FD and CK serve as consultants for Acandis GmbH (Pforzheim, Germany). CK and TL serve as proctors for MicroVention Inc./Sequent Medical (Aliso Viejo, CA, USA). The other authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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For this type of study, formal consent is not required.

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Goertz, L., Hesse, N., Liebig, T. et al. Retreatment strategies for recurrent and residual aneurysms after treatment with flow-diverter devices. Neuroradiology 62, 1019–1028 (2020). https://doi.org/10.1007/s00234-020-02389-w

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  • DOI: https://doi.org/10.1007/s00234-020-02389-w

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