title: Flow changes in the posterior communicating artery related to flow-diverter stents in carotid siphon aneurysms.
abstract: BACKGROUND
  Flow-diverter stent (FDS) placement for treatment of intracranial aneurysms can cause flow changes in the covered branches.
  
  
  OBJECTIVE
  To assess the impact of the treatment of carotid siphon aneurysms with FDS on the posterior communicating artery (PComA) flow.
  
  
  METHODS
  Between February 2011 and January 2015, 125 carotid siphon aneurysms were treated with FDS. We retrospectively analyzed all cases with PComA ostial coverage. The circle of Willis anatomy was also studied as the flow changes in PComA postoperatively and during angiographic follow-up. Data from neurological examination were also collected.
  
  
  RESULTS
  Eighteen aneurysms of the carotid siphon in 17 patients were treated with FDS covering the ostium of the PComA. Based on the initial angiography, patients were divided into two groups: the first with a P1/PComA size ratio >1 (10 cases) and the second with a ratio ≤1 (8 cases). Follow-up angiography (mean time of 10 months) showed 90% of PComA flow changes in group 1 but only 12.5% in group 2. There was a significant difference between the two groups (p=0.002). Nevertheless, no patient had new symptoms related to these flow changes during the follow-up period.
  
  
  CONCLUSIONS
  In our experience, covering the PComA by FDS when treating carotid siphon aneurysms appeared safe and the P1/PComA ratio is a good predictor of flow changes in PComA.
authors.affiliation: Department of Neuroradiologie Interventionnelle, Hôpital Bicetre, Le Kremlin-Bicetre, île-de-France.|Department of Neurorradiologia Diagnóstica e Terapêutica, Hospital Universitário Pedro Ernesto, Rio de Janeiro, Brazil.
authors.forename: Fernando Mota
authors.initials: FM
authors.lastname: de Carvalho
authors.affiliation: Department of Neuroradiologie Interventionnelle, Hôpital Bicetre, Le Kremlin-Bicetre, île-de-France.
authors.forename: Jildaz
authors.identifier: http://orcid.org/0000-0002-0029-1835
authors.initials: J
authors.lastname: Caroff
authors.affiliation: Department of Neurorradiologia Intervencionista, Hospital das Clínicas da Universidade de São Paulo, Brazil.
authors.forename: Elizeu
authors.identifier: http://orcid.org/0000-0002-8791-4440
authors.initials: E
authors.lastname: Pereira Dos Santos Neto
authors.affiliation: Department of Neuroradiologie Interventionnelle, Hôpital Bicetre, Le Kremlin-Bicetre, île-de-France.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Chalumeau
authors.affiliation: Department of Neuropsychiatry, Tanta University Hospital, Tanta, Egypt.
authors.forename: Hazem
authors.initials: H
authors.lastname: Abdel Khalek
authors.affiliation: Department of Neurosurgery, Saitama University, Saitama, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Neki
authors.affiliation: Department of Neuroradiologie Interventionnelle, Hôpital Bicetre, Le Kremlin-Bicetre, île-de-France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Saliou
authors.affiliation: Department of Neuroradiologie Interventionnelle, Hôpital Bicetre, Le Kremlin-Bicetre, île-de-France.
authors.forename: Aymeric
authors.initials: A
authors.lastname: Rouchaud
authors.affiliation: Department of Neuroradiologie Interventionnelle, Hôpital Bicetre, Le Kremlin-Bicetre, île-de-France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Moret
authors.affiliation: Department of Neuroradiologie Interventionnelle, Hôpital Bicetre, Le Kremlin-Bicetre, île-de-France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Spelle
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000502:physiology; D002941:Circle of Willis / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects
keywords: Aneurysm; Flow Diverter; Stent