title: Resolution of mass effect and compression symptoms following endoluminal flow diversion for the treatment of intracranial aneurysms.
abstract: OBJECTIVE
  Alleviation of aneurysm induced mass effect has been difficult with both conventional endovascular and surgical techniques. Our aim was to study the efficacy of endovascular flow modification on aneurysm-induced mass effect and compression syndrome, as demonstrated by cross-sectional imaging studies and clinical follow-up.
  
  
  METHODS
  Thirty aneurysms larger than 10 mm were treated by flow diversion alone and previously had undergone pre- and posttreatment cross-sectional imaging. Pretreatment MR imaging or contrast CT, follow-up angiography at 6 months, and follow-up MR imaging studies between 6 and 18 months were retrospectively analyzed. The neurologic and neuro-ophthalmologic statuses of all patients were recorded before treatment and at the time of follow-up cross-sectional imaging.
  
  
  RESULTS
  At 6 months, 28 aneurysms were completely occluded, 1 had a neck remnant, and 1 had residual filling on angiography. Between 6 and 18 months, 3 aneurysms decreased in size and 27 completely collapsed as demonstrated on MR imaging. Before treatment, 6 patients had vision loss, 10 had double vision due to a third or sixth nerve palsy or both, and 1 had hemiparesis due to brain stem compression. On MR imaging follow-up, vision loss had either improved or resolved in all except 1 patient, double vision had resolved completely (7/10) or partially (3/10), and the patient with brain stem compression became asymptomatic. There was no bleeding observed in this series. One parent artery thrombosis resulted in a major infarct.
  
  
  CONCLUSIONS
  Endovascular flow diversion is a highly effective technique for resolving radiologic mass effect and clinical compression syndromes.
authors.affiliation: Department of Neurointerventions, National Institute of Clinical Neurosciences, Budapest, Hungary. h13424szi@ella.hu
authors.forename: I
authors.initials: I
authors.lastname: Szikora
authors.forename: M
authors.initials: M
authors.lastname: Marosfoi
authors.forename: B
authors.initials: B
authors.lastname: Salomváry
authors.forename: Z
authors.initials: Z
authors.lastname: Berentei
authors.forename: I
authors.initials: I
authors.lastname: Gubucz
mesh_terms: D001807:Blood Vessel Prosthesis; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009408:Nerve Compression Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D015607:Stents; D016896:Treatment Outcome