title: Morphologic and Clinical Outcome of Intracranial Aneurysms after Treatment Using Flow Diverter Devices: Mid-Term Follow-Up.
abstract: Flow diverters (FDs) are designed for the endovascular treatment of complex intracranial aneurysm configurations. From February 2009 to March 2013 28 patients (22 females, 6 males) were treated with FD; mean age was 57 years. Data, including aneurysm features, clinical presentation, history of previous bleeding, treatment, and follow-up results, are presented. Early postinterventional neurological deficits (transient: n = 3/enduring: n = 1) appeared in 4/28 patients (14%), and early improvement of neurological symptoms was observed in 7 patients with previous restriction of cranial nerve function. The overall occlusion rate was 20/26 (77%; 59% after 3 months). 77% achieved best results according to O'Kelly-Marotta score grade D with no contrast material filling (70% of those after 3 months). In 4/6 patients who did not achieve grade D, proximal and/or distal stent overlapping ≥5 mm was not guaranteed sufficiently. During follow-up we did not detect any aneurysm recurrence or haemorrhage. In-stent stenosis emerged as the most frequent complication (4/27; 15%) followed by 2 cases of vascular obliteration (AICA/VA). In conclusion endovascular reconstruction using a FD represents a modern and effective treatment in those aneurysms that are not suitable for conventional interventional or surgical treatment. The appearance of severe complications was rare.
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls University, Hoppe-Seyler-Street 3, 72076 Tübingen, Germany.
authors.forename: Anna-Katharina
authors.initials: AK
authors.lastname: Breu
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls University, Hoppe-Seyler-Street 3, 72076 Tübingen, Germany.
authors.forename: Till-Karsten
authors.initials: TK
authors.lastname: Hauser
authors.affiliation: Department of Neurosurgery, Eberhard Karls University, Hoppe-Seyler-Street 3, 72076 Tübingen, Germany.
authors.forename: Florian H
authors.initials: FH
authors.lastname: Ebner
authors.affiliation: Department of Neurology, Eberhard Karls University, Hoppe-Seyler-Street 3, 72076 Tübingen, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Bischof
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls University, Hoppe-Seyler-Street 3, 72076 Tübingen, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ernemann
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Eberhard Karls University, Hoppe-Seyler-Street 3, 72076 Tübingen, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Seeger