Flow diverter stents for unruptured saccular anterior circulation perforating artery aneurysms: safety, efficacy, and short-term follow-up.

Authors

Anna Luisa Kühn
Samuel Y Hou, Division of Neuroimaging and Intervention, Department of Radiology and New England Center for Stroke Research, University of Massachusetts, Worcester, Massachusetts, USA.Follow
Mary Perras
Christopher Brooks
Matthew J Gounis
Ajay K Wakhloo
Ajit S Puri

Document Type

Article

Publication Date

9-1-2015

Publication Title

J Neurointerv Surg

Keywords

Aged; Angiography, Digital Subtraction; Cerebral Angiography; Embolization, Therapeutic; Female; Follow-Up Studies; Humans; Intracranial Aneurysm; Male; Middle Aged; Retrospective Studies; Stents; Tomography, X-Ray Computed; Treatment Outcome

Abstract

BACKGROUND: Anterior circulation perforating artery aneurysms including anterior choroidal artery and lenticulostriate artery aneurysms are rare. Injury to these vessels can lead to severe debilitating symptoms.

OBJECTIVE: To present a new approach to treatment using flow diversion technology.

METHODS: Patients treated with a Pipeline embolization device (PED) for perforator artery aneurysms at our institution between June 2012 and May 2013 were identified and included in our retrospective analysis. We evaluated patient vascular risk factors; family history of aneurysms; aneurysm characteristics; National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) on admission; and angiography follow-up and patient clinical outcome at discharge, 6 months, and 1 year.

RESULTS: We included four patients with a mean age of 59.8 years. Two patients had a positive family history of aneurysms. Patient vascular risk factors included smoking, dyslipidemia, and hypertension. All patients presented with a NIHSS and mRS of 0 on admission. Aneurysms were located at the anterior choroidal (n=2) or lenticulostriate artery (n=2) and were treated with a single PED. No periprocedural or postprocedural complications occurred. The patients were discharged with no change in NHISS or mRS score. Six-month and 1-year follow-up angiography showed complete aneurysm occlusion. Mild intimal hyperplasia was seen in 2 cases at 6 months, but was resolved at the 1-year follow-up. No re-treatment was necessary. NIHSS and mRS remained 0 at follow-up time points.

CONCLUSIONS: Our preliminary results show that flow diversion technology is an effective and safe therapy for complex, hard-to-treat aneurysms in perforating arteries. Larger studies with long-term follow-up are needed to validate our promising results.

Clinical Institute

Neurosciences (Brain & Spine)

Department

Neurosciences

Comments

Samuel Hou is affiliated with Providence St. Joseph Health.

Recommended Citation

Kühn, Anna Luisa; Hou, Samuel Y; Perras, Mary; Brooks, Christopher; Gounis, Matthew J; Wakhloo, Ajay K; and Puri, Ajit S, "Flow diverter stents for unruptured saccular anterior circulation perforating artery aneurysms: safety, efficacy, and short-term follow-up." (2015). Articles, Abstracts, and Reports. 878.
https://digitalcommons.providence.org/publications/878