title: Flow diverter device for the treatment of small middle cerebral artery aneurysms.
abstract: OBJECTIVE
  Experience with the endovascular treatment of middle cerebral artery (MCA) aneurysms by flow diverter devices (FDD) is still limited. This study examines the results and complications of FDD for small aneurysms at this location.
  
  
  METHODS
  From February 2010 to December 2013, 14 patients (10 women; mean age 59 years) with 15 small MCA aneurysms were treated with FDD. All procedures were performed with the Pipeline embolization device (PED).
  
  
  RESULTS
  Complete occlusion was obtained in 12/15 aneurysms (80%) and partial occlusion in 3 (20%). Among 13 aneurysms with a side branch, this was patent at the angiographic control in 4 cases, showed decreased filling in 6, and was occluded in 3 (with neurological deficits in 2). All PEDs were patent at follow-up. Post-procedural ischemic complications occurred in 4 (27%) procedures with permanent neurological deficit (modified Rankin score 2) in 3 (21%). No early or delayed aneurysm rupture, no subarachnoid or intraparenchymal hemorrhage and no deaths occurred.
  
  
  CONCLUSIONS
  Endovascular treatment with FDD is a relatively safe treatment for small MCA aneurysms resulting in a high occlusion rate. The findings of this study suggest that complete occlusion after endovascular treatment with FDD can be delayed (>6 months). Ischemic complications may occur as early or delayed, particularly at clopidogrel interruption.
authors.affiliation: Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Briganti
authors.affiliation: Unit of Interventional Neuroradiology, San Giovanni Bosco Hospital, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Delehaye
authors.affiliation: Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Leone
authors.affiliation: Unit of Interventional Neuroradiology, San Giovanni Bosco Hospital, Naples, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Sicignano
authors.affiliation: Unit of Interventional Neuroradiology, San Giovanni Bosco Hospital, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Buono
authors.affiliation: Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
authors.forename: Mariano
authors.initials: M
authors.lastname: Marseglia
authors.affiliation: Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Caranci
authors.affiliation: "Magrassi Lanzara" Clinical-Surgical Department, Second University of Naples, Naples, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Tortora
authors.affiliation: Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Maiuri
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
keywords: Aneurysm; Angiography; Flow Diverter; Intervention