title: Early angiographic changes of intra-aneurysmal flow after flow-diverter stent treatment are not predictive of therapeutic success.
abstract: OBJECTIVE
  Flow-diverter stents (FDS) are new devices for the endovascular treatment of intracranial aneurysms (IAs) promoting progressive aneurysmal thrombosis. To date, the delay of aneurysmal exclusion remains unclear. We evaluated the correlation between angiographic changes in the first 24 hours and 12-month occlusion in aneurysms treated with FDS.
  
  
  METHODS
  We retrospectively analyzed the intra-aneurysmal flow by evaluating the in-flow and out-flow delays on preoperative, immediate postoperative, 24-hour and 12-month follow-up angiography. Dichotomy of in-flow and out-flow within the aneurysm was considered as the time of contrast filling and time of contrast washing relatively to the parent artery. The delay times were compared and correlated with the therapeutic success of FDS at 12 months of follow-up.
  
  
  RESULTS
  Out of 14 treated IAs, in 13 consecutive patients, n = 10 (71%) aneurysms showed complete occlusion at 12 months. Between immediate postoperative and 24-hour control, 10 aneurysms (71%) demonstrated in-flow modification, with eight increasing, two decreasing and four having no change. There were no statistical differences in therapeutic success in relation to the different flow-related profiles of intra-aneurysmal flux.Out-flow modifications were found in 11 aneurysms (79%) between immediate postoperative and 24-hour control, with five increasing, six decreasing and three having no change. Similar to the in-flow changes, there were no statistical differences in therapeutic success relative to the flow-related profiles.
  
  
  CONCLUSIONS
  Early angiographic changes after FDS placement are very frequent, but are not correlated with the 12-month technical success of flow-diversion techniques.
authors: FHU IRIS, Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France.
authors: Paul-Emile
authors: PE
authors: Labeyrie
authors: FHU IRIS, Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France benjamin.gory@chu-lyon.fr.
authors: Benjamin
authors: B
authors: Gory
authors: FHU IRIS, Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France.
authors: Udi
authors: U
authors: Sadeh-Gonike
authors: FHU IRIS, Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France.
authors: Nazyed
authors: N
authors: Huguet
authors: FHU IRIS, Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France.
authors: Rotem
authors: R
authors: Sivan-Hoffmann
authors: FHU IRIS, Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France.
authors: Roberto
authors: R
authors: Riva
authors: Department of Interventional Neuroradiology, Hôpital Cote de Nâcre, CHU de Caen, France.
authors: Patrick
authors: P
authors: Courthéoux
authors: FHU IRIS, Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France.
authors: Francis
authors: F
authors: Turjman
mesh_terms: D000368:Aged; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D057510:Endovascular Procedures / Q000379:methods*; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Brain aneurysm; endovascular therapies; flow diverter