Italian multicenter experience with flow-diverter devices for intracranial unruptured aneurysm treatment with periprocedural complications—a retrospective data analysis

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.

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Conflict of interest

F. Briganti, E. Boccardi, M. Isalberti, N.P. Nuzzi, and L.P. Valvassori Bolgè serve as proctors for EV3 and receive modest remuneration. E. Boccardi and L.P Valvassori Bolgè serve as proctors for BALT and receive modest remuneration. E.C Cagliari serves as a proctor for EV3 without remuneration.

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Correspondence to Francesco Briganti.

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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 54, 1145–1152 (2012). https://doi.org/10.1007/s00234-012-1047-3

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Keywords

  • Flow diverter device
  • Pipeline embolization device
  • Silk embolization device
  • Intracranial aneurysms
  • Endovascular treatment