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Paraclinoid Aneurysms: Flow Diverters and Endovascular Treatment

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Controversies in Vascular Neurosurgery

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Abstract

Paraclinoid aneurysms arise from the internal carotid artery, located adjacent to the anterior clinoid process between the distal dural ring at the end of the cavernous segment and the origin of the posterior communicating artery. These aneurysms are among the commonest intracranial aneurysms, comprising 30 % of all intracranial aneurysms. Endovascular treatment of paraclinoid aneurysm has evolved since the introduction of the Guglielmi detachable coil in the 1990s. In this chapter, we discuss complications and radiological and clinical outcomes of various endovascular management options from primary coiling to the most recent application of flow-diverter devices.

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Abbreviations

ACT:

activated coagulation time

AP:

anteroposterior

BTO:

balloon test occlusion

CBF:

cerebral blood flow

CE:

Conformité Européene

ECA:

external carotid artery

F:

French

FDA:

Food and Drug Administration

FRED:

Flow-Redirection Endoluminal Device

GDC:

Guglielmi detachable coil

ICA:

internal carotid artery

ISAT:

International Subarachnoid Aneurysm Trial

ISUIA:

International Study of Unruptured Intracranial Aneurysms

PComA:

posterior communicating artery

PED:

Pipeline embolization device

PUFS:

Pipeline for Uncoilable or Failed Aneurysms

rSO2 :

regional oxygen saturation

SAH:

subarachnoid hemorrhage

SCENT:

Safety and Effectiveness of an Intracranial Aneurysm Embolization System for Treating Large or Giant Wide Neck Aneurysms

SPECT:

single photon emission computed tomography

SSEPs:

somatosensory evoked potentials

TIA:

transient ischemic attack

References

  1. Day AL. Aneurysms of the ophthalmic segment. A clinical and anatomical analysis. J Neurosurg. 1990;72:677–91.

    Article  CAS  PubMed  Google Scholar 

  2. Drake CG, Vanderlinden RG, Amacher AL. Carotid-ophthalmic aneurysms. J Neurosurg. 1968;29:24–31.

    Article  CAS  PubMed  Google Scholar 

  3. Seifert V, Guresir E, Vatter H. Exclusively intradural exposure and clip reconstruction in complex paraclinoid aneurysms. Acta Neurochir (Wien). 2011;153:2103–9.

    Article  Google Scholar 

  4. D’Urso PI, Karadeli HH, Kallmes DF, et al. Coiling for paraclinoid aneurysms: time to make way for flow diverters? AJNR Am J Neuroradiol. 2012;33:1470–4.

    Article  PubMed  Google Scholar 

  5. Lanzino G, Crobeddu E, Cloft HJ, et al. Efficacy and safety of flow diversion for paraclinoid aneurysms: a matched-pair analysis compared with standard endovascular approaches. AJNR Am J Neuroradiol. 2012;33:2158–61.

    Article  CAS  PubMed  Google Scholar 

  6. Thornton J, Aletich VA, Debrun GM, et al. Endovascular treatment of paraclinoid aneurysms. Surg Neurol. 2000;54:288–99.

    Article  CAS  PubMed  Google Scholar 

  7. Wiebers DO, Whisnant JP, Huston 3rd J, et al. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet. 2003;362:103–10.

    Article  PubMed  Google Scholar 

  8. Molyneux AJ, Kerr RS, Yu LM, et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet. 2005;366:809–17.

    Article  PubMed  Google Scholar 

  9. Molyneux AJ, Birks J, Clarke A, et al. The durability of endovascular coiling versus neurosurgical clipping of ruptured cerebral aneurysms: 18 year follow-up of the UK cohort of the International Subarachnoid Aneurysm Trial (ISAT). Lancet. 2015;385:691–7.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Becske T, Kallmes DF, Saatci I, et al. Pipeline for uncoilable or failed aneurysms: results from a multicenter clinical trial. Radiology. 2013;267:858–68.

    Article  PubMed  Google Scholar 

  11. De Jesus O, Sekhar LN, Riedel CJ. Clinoid and paraclinoid aneurysms: surgical anatomy, operative techniques, and outcome. Surg Neurol. 1999;51:477–87. discussion 87–8.

    Article  PubMed  Google Scholar 

  12. Joo W, Funaki T, Yoshioka F, et al. Microsurgical anatomy of the carotid cave. Neurosurgery. 2012;70:300–11. discussion 11–2.

    PubMed  Google Scholar 

  13. Kim JM, Romano A, Sanan A, et al. Microsurgical anatomic features and nomenclature of the paraclinoid region. Neurosurgery. 2000;46:670–80. discussion 80–2.

    Article  CAS  PubMed  Google Scholar 

  14. Nutik S. Carotid paraclinoid aneurysms with intradural origin and intracavernous location. J Neurosurg. 1978;48:526–33.

    Article  CAS  PubMed  Google Scholar 

  15. Gibo H, Lenkey C, Rhoton Jr AL. Microsurgical anatomy of the supraclinoid portion of the internal carotid artery. J Neurosurg. 1981;55:560–74.

    Article  CAS  PubMed  Google Scholar 

  16. Bouthillier A, van Loveren HR, Keller JT. Segments of the internal carotid artery: a new classification. Neurosurgery. 1996;38:425–32. discussion 32–3.

    CAS  PubMed  Google Scholar 

  17. Batjer HH, Kopitnik TA, Giller CA, et al. Surgery for paraclinoidal carotid artery aneurysms. J Neurosurg. 1994;80:650–8.

    Article  CAS  PubMed  Google Scholar 

  18. Lasjaunias P, Santoyo-Vazquez A. Segmental agenesis of the internal carotid artery: angiographic aspects with embryological discussion. Anat Clin. 1984;6:133–41.

    Article  CAS  PubMed  Google Scholar 

  19. Shapiro M, Becske T, Riina HA, et al. Toward an endovascular internal carotid artery classification system. AJNR Am J Neuroradiol. 2014;35:230–6.

    Article  CAS  PubMed  Google Scholar 

  20. Locksley HB. Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the cooperative study. J Neurosurg. 1966;25:219–39.

    Article  CAS  PubMed  Google Scholar 

  21. International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms--risk of rupture and risks of surgical intervention. N Engl J Med. 1998;339:1725–33.

    Article  Google Scholar 

  22. Juvela S, Poussa K, Lehto H, et al. Natural history of unruptured intracranial aneurysms: a long-term follow-up study. Stroke. 2013;44:2414–21.

    Article  PubMed  Google Scholar 

  23. Sonobe M, Yamazaki T, Yonekura M, et al. Small unruptured intracranial aneurysm verification study: SUAVe study, Japan. Stroke. 2010;41:1969–77.

    Article  PubMed  Google Scholar 

  24. Brinjikji W, Rabinstein AA, Nasr DM, et al. Better outcomes with treatment by coiling relative to clipping of unruptured intracranial aneurysms in the United States, 2001–2008. AJNR Am J Neuroradiol. 2011;32:1071–5.

    Article  CAS  PubMed  Google Scholar 

  25. Naggara ON, White PM, Guilbert F, et al. Endovascular treatment of intracranial unruptured aneurysms: systematic review and meta-analysis of the literature on safety and efficacy. Radiology. 2010;256:887–97.

    Article  PubMed  Google Scholar 

  26. Greving JP, Wermer MJ, Brown Jr RD, et al. Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol. 2014;13:59–66.

    Article  PubMed  Google Scholar 

  27. Tanaka Y, Hongo K, Tada T, et al. Radiometric analysis of paraclinoid carotid artery aneurysms. J Neurosurg. 2002;96:649–53.

    Article  PubMed  Google Scholar 

  28. Date I, Asari S, Ohmoto T. Cerebral aneurysms causing visual symptoms: their features and surgical outcome. Clin Neurol Neurosurg. 1998;100:259–67.

    Article  CAS  PubMed  Google Scholar 

  29. Ferguson GG, Drake CG. Carotid-ophthalmic aneurysms: visual abnormalities in 32 patients and the results of treatment. Surg Neurol. 1981;16:1–8.

    Article  CAS  PubMed  Google Scholar 

  30. Nonaka T, Haraguchi K, Baba T, et al. Clinical manifestations and surgical results for paraclinoid cerebral aneurysms presenting with visual symptoms. Surg Neurol. 2007;67:612–9. discussion 19.

    Article  PubMed  Google Scholar 

  31. Shimizu T, Naito I, Aihara M, et al. Visual outcomes of endovascular and microsurgical treatment for large or giant paraclinoid aneurysms. Acta Neurochir (Wien). 2015;157:13–20.

    Article  Google Scholar 

  32. de Oliveira JG, Borba LA, Rassi-Neto A, et al. Intracranial aneurysms presenting with mass effect over the anterior optic pathways: neurosurgical management and outcomes. Neurosurg Focus. 2009;26, E3.

    Article  PubMed  Google Scholar 

  33. Schuss P, Guresir E, Berkefeld J, et al. Influence of surgical or endovascular treatment on visual symptoms caused by intracranial aneurysms: single-center series and systematic review. J Neurosurg. 2011;115:694–9.

    Article  PubMed  Google Scholar 

  34. Kumon Y, Sakaki S, Kohno K, et al. Asymptomatic, unruptured carotid-ophthalmic artery aneurysms: angiographical differentiation of each type, operative results, and indications. Surg Neurol. 1997;48:465–72.

    Article  CAS  PubMed  Google Scholar 

  35. Almeida GM, Shibata MK, Bianco E. Carotid-ophthalmic aneurysms. Surg Neurol. 1976;5:41–5.

    CAS  PubMed  Google Scholar 

  36. Guidetti B, La Torre E. Carotid-ophthalmic aneurysms. A series of 16 cases treated by direct approach. Acta Neurochir (Wien). 1970;22:289–304.

    Article  CAS  Google Scholar 

  37. Heran NS, Song JK, Kupersmith MJ, et al. Large ophthalmic segment aneurysms with anterior optic pathway compression: assessment of anatomical and visual outcomes after endosaccular coil therapy. J Neurosurg. 2007;106:968–75.

    Article  PubMed  Google Scholar 

  38. Kazekawa K, Tsutsumi M, Aikawa H, et al. Internal carotid aneurysms presenting with mass effect symptoms of cranial nerve dysfunction: efficacy and imitations of endosaccular embolization with GDC. Radiat Med. 2003;21:80–5.

    PubMed  Google Scholar 

  39. Brooks B. The treatment of traumatic arteriovenous fistula. South Med J. 1930;23:00–1.

    Google Scholar 

  40. Serbinenko FA. Balloon catheterization and occlusion of major cerebral vessels. J Neurosurg. 1974;41:125–45.

    Article  CAS  PubMed  Google Scholar 

  41. Higashida RT, Halbach VV, Dowd C, et al. Endovascular detachable balloon embolization therapy of cavernous carotid artery aneurysms: results in 87 cases. J Neurosurg. 1990;72:857–63.

    Article  CAS  PubMed  Google Scholar 

  42. van der Schaaf IC, Brilstra EH, Buskens E, et al. Endovascular treatment of aneurysms in the cavernous sinus: a systematic review on balloon occlusion of the parent vessel and embolization with coils. Stroke. 2002;33:313–8.

    Article  PubMed  Google Scholar 

  43. Chen PR, Ortiz R, Page JH, et al. Spontaneous systolic blood pressure elevation during temporary balloon occlusion increases the risk of ischemic events after carotid artery occlusion. Neurosurgery. 2008;63:256–64. discussion 64–5.

    Article  PubMed  Google Scholar 

  44. Briganti F, Cirillo S, Caranci F, et al. Development of “de novo” aneurysms following endovascular procedures. Neuroradiology. 2002;44:604–9.

    Article  CAS  PubMed  Google Scholar 

  45. Standard SC, Ahuja A, Guterman LR, et al. Balloon test occlusion of the internal carotid artery with hypotensive challenge. AJNR Am J Neuroradiol. 1995;16:1453–8.

    CAS  PubMed  Google Scholar 

  46. Ahn JH, Cho YD, Kang HS, et al. Endovascular treatment of ophthalmic artery aneurysms: assessing balloon test occlusion and preservation of vision in coil embolization. AJNR Am J Neuroradiol. 2014;35:2146–52.

    Article  CAS  PubMed  Google Scholar 

  47. Marshall RS, Lazar RM, Mohr JP, et al. Higher cerebral function and hemispheric blood flow during awake carotid artery balloon test occlusions. J Neurol Neurosurg Psychiatry. 1999;66:734–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Kaminogo M, Ochi M, Onizuka M, et al. An additional monitoring of regional cerebral oxygen saturation to HMPAO SPECT study during balloon test occlusion. Stroke. 1999;30:407–13.

    Article  CAS  PubMed  Google Scholar 

  49. Liu AY, Lopez JR, Do HM, et al. Neurophysiological monitoring in the endovascular therapy of aneurysms. AJNR Am J Neuroradiol. 2003;24:1520–7.

    PubMed  Google Scholar 

  50. Mathis JM, Barr JD, Jungreis CA, et al. Temporary balloon test occlusion of the internal carotid artery: experience in 500 cases. AJNR Am J Neuroradiol. 1995;16:749–54.

    CAS  PubMed  Google Scholar 

  51. Park HK, Horowitz M, Jungreis C, et al. Endovascular treatment of paraclinoid aneurysms: experience with 73 patients. Neurosurgery. 2003;53:14–23. discussion 24.

    Article  PubMed  Google Scholar 

  52. Kwon WH, Jeong HW, Kim ST, et al. Angiographic and clinical result of endovascular treatment in paraclinoid aneurysms. Neurointervention. 2014;9:83–8.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Kwon OK, Kim SH, Kwon BJ, et al. Endovascular treatment of wide-necked aneurysms by using two microcatheters: techniques and outcomes in 25 patients. AJNR Am J Neuroradiol. 2005;26:894–900.

    PubMed  Google Scholar 

  54. Kwon OK, Kim SH, Oh CW, et al. Embolization of wide-necked aneurysms with using three or more microcatheters. Acta Neurochir (Wien). 2006;148:1139–45. discussion 45.

    Article  Google Scholar 

  55. Toyota S, Fujimoto Y, Iwamoto F, et al. Technique for shaping microcatheter tips in coil embolization of paraclinoid aneurysms using full-scale volume rendering images of 3D rotational angiography. Minim Invasive Neurosurg. 2009;52:201–3.

    Article  CAS  PubMed  Google Scholar 

  56. Cho YD, Rhim JK, Park JJ, et al. Microcatheter Looping to Facilitate Aneurysm Selection in Coil Embolization of Paraclinoid Aneurysms. Korean J Radiol. 2015;16:899–905.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Kwon BJ, Im SH, Park JC, et al. Shaping and navigating methods of microcatheters for endovascular treatment of paraclinoid aneurysms. Neurosurgery. 2010;67:34–40. discussion 40.

    Article  PubMed  Google Scholar 

  58. Chalouhi N, Jabbour P, Singhal S, et al. Stent-assisted coiling of intracranial aneurysms: predictors of complications, recanalization, and outcome in 508 cases. Stroke. 2013;44:1348–53.

    Article  PubMed  Google Scholar 

  59. Ogilvy CS, Natarajan SK, Jahshan S, et al. Stent-assisted coiling of paraclinoid aneurysms: risks and effectiveness. J Neurointerv Surg. 2011;3:14–20.

    Article  PubMed  Google Scholar 

  60. Wang Y, Li Y, Jiang C, et al. Endovascular treatment of paraclinoid aneurysms: 142 aneurysms in one centre. J Neurointerv Surg. 2013;5:552–6.

    Article  PubMed  Google Scholar 

  61. Kadkhodayan Y, Rhodes N, Blackburn S, et al. Comparison of Enterprise with Neuroform stent-assisted coiling of intracranial aneurysms. AJR Am J Roentgenol. 2013;200:872–8.

    Article  PubMed  Google Scholar 

  62. King B, Vaziri S, Singla A, et al. Clinical and angiographic outcomes after stent-assisted coiling of cerebral aneurysms with Enterprise and Neuroform stents: a comparative analysis of the literature. J Neurointerv Surg. 2015;7(12):905–9.

    Article  PubMed  Google Scholar 

  63. Chen Z, Yang Y, Miao H, et al. Experiences and complications in endovascular treatment of paraclinoid aneurysms. J Clin Neurosci. 2013;20:1259–63.

    Article  PubMed  Google Scholar 

  64. Sorimachi T, Ito Y, Morita K, et al. Long-term follow-up of intra-aneurysmal coil embolization for unruptured paraclinoid aneurysms. Neurol Res. 2012;34:864–70.

    Article  PubMed  Google Scholar 

  65. Yadla S, Campbell PG, Grobelny B, et al. Open and endovascular treatment of unruptured carotid-ophthalmic aneurysms: clinical and radiographic outcomes. Neurosurgery. 2011;68:1434–43. discussion 43.

    PubMed  Google Scholar 

  66. Campi A, Ramzi N, Molyneux AJ, et al. Retreatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the International Subarachnoid Aneurysm Trial (ISAT). Stroke. 2007;38:1538–44.

    Article  PubMed  Google Scholar 

  67. Gandhi CD, Bulsara KR, Fifi J, et al. Platelet function inhibitors and platelet function testing in neurointerventional procedures. J Neurointerv Surg. 2014;6:567–77.

    Article  PubMed  Google Scholar 

  68. Delgado Almandoz JE, Crandall BM, Scholz JM, et al. Pre-procedure P2Y12 reaction units value predicts perioperative thromboembolic and hemorrhagic complications in patients with cerebral aneurysms treated with the Pipeline Embolization Device. J Neurointerv Surg. 2013;5 Suppl 3:iii3–10.

    Article  PubMed  Google Scholar 

  69. Delgado Almandoz JE, Crandall BM, Scholz JM, et al. Last-recorded P2Y12 reaction units value is strongly associated with thromboembolic and hemorrhagic complications occurring up to 6 months after treatment in patients with cerebral aneurysms treated with the pipeline embolization device. AJNR Am J Neuroradiol. 2014;35:128–35.

    Article  CAS  PubMed  Google Scholar 

  70. Delgado Almandoz JE, Kadkhodayan Y, Crandall BM, et al. Variability in initial response to standard clopidogrel therapy, delayed conversion to clopidogrel hyper-response, and associated thromboembolic and hemorrhagic complications in patients undergoing endovascular treatment of unruptured cerebral aneurysms. J Neurointerv Surg. 2014;6:767–73.

    Article  PubMed  Google Scholar 

  71. Shapiro M, Raz E, Becske T, et al. Variable porosity of the Pipeline embolization device in straight and curved vessels: a guide for optimal deployment strategy. AJNR Am J Neuroradiol. 2014;35:727–33.

    Article  CAS  PubMed  Google Scholar 

  72. Ma D, Xiang J, Choi H, et al. Enhanced aneurysmal flow diversion using a dynamic push-pull technique: an experimental and modeling study. AJNR Am J Neuroradiol. 2014;35:1779–85.

    Article  CAS  PubMed  Google Scholar 

  73. Shapiro M, Raz E, Becske T, et al. Building multidevice Pipeline constructs of favorable metal coverage: a practical guide. AJNR Am J Neuroradiol. 2014;35:1556–61.

    Article  CAS  PubMed  Google Scholar 

  74. Puffer RC, Kallmes DF, Cloft HJ, et al. Patency of the ophthalmic artery after flow diversion treatment of paraclinoid aneurysms. J Neurosurg. 2012;116:892–6.

    Article  PubMed  Google Scholar 

  75. Lin N, Brouillard AM, Krishna C, et al. Use of coils in conjunction with the Pipeline embolization device for treatment of intracranial aneurysms. Neurosurgery. 2015;76:142–9.

    Article  PubMed  Google Scholar 

  76. Leung GK, Tsang AC, Lui WM. Pipeline embolization device for intracranial aneurysm: a systematic review. Clin Neuroradiol. 2012;22:295–303.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Kallmes DF, Hanel R, Lopes D, et al. International retrospective study of the Pipeline embolization device: a multicenter aneurysm treatment study. AJNR Am J Neuroradiol. 2015;36:108–15.

    Article  CAS  PubMed  Google Scholar 

  78. Lylyk P, Miranda C, Ceratto R, et al. Curative endovascular reconstruction of cerebral aneurysms with the pipeline embolization device: the Buenos Aires experience. Neurosurgery. 2009;64:632–42; discussion 42–3; quiz N6.

    Article  PubMed  Google Scholar 

  79. Berge J, Biondi A, Machi P, et al. Flow-diverter Silk stent for the treatment of intracranial aneurysms: 1-year follow-up in a multicenter study. AJNR Am J Neuroradiol. 2012;33:1150–5.

    Article  CAS  PubMed  Google Scholar 

  80. Briganti F, Napoli M, Tortora F, et al. Italian multicenter experience with flow-diverter devices for intracranial unruptured aneurysm treatment with periprocedural complications--a retrospective data analysis. Neuroradiology. 2012;54:1145–52.

    Article  PubMed  Google Scholar 

  81. Fischer S, Vajda Z, Aguilar Perez M, et al. Pipeline embolization device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections. Neuroradiology. 2012;54:369–82.

    Article  PubMed  Google Scholar 

  82. Kan P, Siddiqui AH, Veznedaroglu E, et al. Early postmarket results after treatment of intracranial aneurysms with the Pipeline embolization device: a U.S. multicenter experience. Neurosurgery. 2012;71:1080–7; discussion 87–8.

    Article  PubMed  Google Scholar 

  83. Piano M, Valvassori L, Quilici L, et al. Midterm and long-term follow-up of cerebral aneurysms treated with flow diverter devices: a single-center experience. J Neurosurg. 2013;118:408–16.

    Article  PubMed  Google Scholar 

  84. Saatci I, Yavuz K, Ozer C, et al. Treatment of intracranial aneurysms using the Pipeline flow-diverter embolization device: a single-center experience with long-term follow-up results. AJNR Am J Neuroradiol. 2012;33:1436–46.

    Article  CAS  PubMed  Google Scholar 

  85. Velioglu M, Kizilkilic O, Selcuk H, et al. Early and midterm results of complex cerebral aneurysms treated with Silk stent. Neuroradiology. 2012;54:1355–65.

    Article  PubMed  Google Scholar 

  86. Yu SC, Kwok CK, Cheng PW, et al. Intracranial aneurysms: midterm outcome of Pipeline embolization device--a prospective study in 143 patients with 178 aneurysms. Radiology. 2012;265:893–901.

    Article  PubMed  Google Scholar 

  87. Chan RS, Mak CH, Wong AK, et al. Use of the Pipeline embolization device to treat recently ruptured dissecting cerebral aneurysms. Interv Neuroradiol. 2014;20:436–41.

    PubMed  PubMed Central  Google Scholar 

  88. Lin N, Brouillard AM, Keigher KM, et al. Utilization of Pipeline embolization device for treatment of ruptured intracranial aneurysms: US multicenter experience. J Neurointerv Surg. 2015;7(11):808–15.

    Article  PubMed  Google Scholar 

  89. Chalouhi N, Zanaty M, Whiting A, et al. Treatment of ruptured intracranial aneurysms with the pipeline embolization device. Neurosurgery. 2015;76:165–72. discussion 72.

    Article  PubMed  Google Scholar 

  90. Yoon JW, Siddiqui AH, Dumont TM, et al. Feasibility and safety of Pipeline embolization device in patients with ruptured carotid blister aneurysms. Neurosurgery. 2014;75:419–29. discussion 29.

    Article  PubMed  Google Scholar 

  91. Lubicz B, Van der Elst O, Collignon L, et al. Silk flow-diverter stent for the treatment of intracranial aneurysms: a series of 58 patients with emphasis on long-term results. AJNR Am J Neuroradiol. 2015;36:542–6.

    Article  CAS  PubMed  Google Scholar 

  92. Colby GP, Lin LM, Caplan JM, et al. Immediate procedural outcomes in 44 consecutive Pipeline Flex cases: the first North American single-center series. J Neurointerv Surg 2015. Epub July 1 2015

    Google Scholar 

  93. Duckworth EA, Nickele C, Hoit D, et al. The first North American use of the Pipeline Flex flow diverter. BMJ Case Rep. 2015;30:2015.

    Google Scholar 

  94. Martinez-Galdamez M, Gil A, Caniego JL, et al. Preliminary experience with the Pipeline Flex Embolization Device: technical note. J Neurointerv Surg. 2015;7(10):748–51.

    Article  CAS  PubMed  Google Scholar 

  95. Martinez-Galdamez M, Perez S, Vega A, et al. Endovascular treatment of intracranial aneurysms using the Pipeline Flex embolization device: a case series of 30 consecutive patients. J Neurointerv Surg. 2016;8(4):396–401.

    Article  CAS  PubMed  Google Scholar 

  96. Diaz O, Gist TL, Manjarez G, et al. Treatment of 14 intracranial aneurysms with the FRED system. J Neurointerv Surg. 2014;6:614–7.

    Article  PubMed  Google Scholar 

  97. Mohlenbruch MA, Herweh C, Jestaedt L, et al. The FRED Flow-Diverter Stent for Intracranial Aneurysms: Clinical Study to Assess Safety and Efficacy. AJNR Am J Neuroradiol. 2015;36:1155–61.

    Article  CAS  PubMed  Google Scholar 

  98. Poncyljusz W, Sagan L, Safranow K, et al. Initial experience with implantation of novel dual layer flow-diverter device FRED. Wideochir Inne Tech Maloinwazyjne. 2013;8:258–64.

    PubMed  PubMed Central  Google Scholar 

  99. De Vries J, Boogaarts J, Van Norden A, et al. New generation of flow diverter (Surpass) for unruptured intracranial aneurysms: a prospective single-center study in 37 patients. Stroke. 2013;44:1567–77.

    Article  PubMed  Google Scholar 

  100. Safety and Effectiveness of an Intracranial Aneurysm Embolization System for Treating Large or Giant Wide Neck Aneurysms (SCENT). NCT01716117. ClinicalTrials.gov [Internet]. [cited 2015 Jul 28]. Available from: https://clinicaltrials.gov/ct2/show/NCT01716117.

  101. Chalouhi N, Tjoumakaris S, Starke RM, et al. Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms. Stroke. 2013;44:2150–4.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA

    Ashish Sonig MD MS MCh

  2. Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, NY, USA

    Ashish Sonig MD MS MCh, L. Nelson Hopkins MD FACS, Kenneth V. Snyder MD PhD, Elad I. Levy MD MBA FACS FAHA FAANS & Adnan H. Siddiqui MD PhD FAHA FAANS

  3. Departments of Neurosurgery and Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA

    L. Nelson Hopkins MD FACS, Elad I. Levy MD MBA FACS FAHA FAANS & Adnan H. Siddiqui MD PhD FAHA FAANS

  4. Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, NY, USA

    L. Nelson Hopkins MD FACS, Kenneth V. Snyder MD PhD, Elad I. Levy MD MBA FACS FAHA FAANS & Adnan H. Siddiqui MD PhD FAHA FAANS

  5. Jacobs Institute, Buffalo, NY, USA

    L. Nelson Hopkins MD FACS & Adnan H. Siddiqui MD PhD FAHA FAANS

  6. Departments of Neurosurgery, Radiology, and Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA

    Kenneth V. Snyder MD PhD

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  1. Ashish Sonig MD MS MCh
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Correspondence to Adnan H. Siddiqui MD PhD FAHA FAANS .

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  1. Neuroscience Inst. Dept. of Neurosurgery, Drexel Univ. College of Medicine, Drexel, Philadelphia, Pennsylvania, USA

    Erol Veznedaroglu

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Sonig, A., Hopkins, L.N., Snyder, K.V., Levy, E.I., Siddiqui, A.H. (2016). Paraclinoid Aneurysms: Flow Diverters and Endovascular Treatment. In: Veznedaroglu, E. (eds) Controversies in Vascular Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-27315-0_2

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  • DOI: https://doi.org/10.1007/978-3-319-27315-0_2

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