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Safety and efficacy of coated flow diverters in the treatment of ruptured intracranial aneurysms: a retrospective multicenter study

Background This multicenter study evaluated the safety and efficacy of coated flow diverters (cFDs) for the treatment of ruptured intracranial aneurysms. - Methods Consecutive patients treated with different cFDs for ruptured aneurysms under tirofiban at eight neurovascular centers between 2016 and...

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Main Authors: Görtz, Lukas (Author) , Hohenstatt, Sophia (Author) , Vollherbst, Dominik (Author) , Weyland, Charlotte Sabine (Author) , Nikoubashman, Omid (Author) , Styczen, Hanna (Author) , Gronemann, Christian (Author) , Weiss, Daniel (Author) , Kaschner, Marius (Author) , Pflaeging, Muriel (Author) , Siebert, Eberhard (Author) , Zopfs, David (Author) , Kottlors, Jonathan (Author) , Pennig, Lenhard (Author) , Schlamann, Marc (Author) , Bohner, Georg (Author) , Liebig, Thomas (Author) , Turowski, Bernd (Author) , Dorn, Franziska (Author) , Deuschl, Cornelius (Author) , Wiesmann, Martin (Author) , Möhlenbruch, Markus Alfred (Author) , Kabbasch, Christoph (Author)
Format: Article (Journal)
Language:English
Published: 2025
Edition:Early view
In: Journal of neuroInterventional surgery
Year: 2025, Volume: 17, Issue: 3, Pages: 304–310
ISSN:1759-8486
DOI:10.1136/jnis-2024-021516
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1136/jnis-2024-021516
Verlag, lizenzpflichtig, Volltext: https://jnis.bmj.com/content/early/2024/04/03/jnis-2024-021516
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Author Notes:Lukas Goertz, Sophia Hohenstatt, Dominik F. Vollherbst, Charlotte Sabine Weyland, Omid Nikoubashman, Hanna Styczen, Christian Gronemann, Daniel Weiss, Marius Kaschner, Muriel Pflaeging, Eberhard Siebert, David Zopfs, Jonathan Kottlors, Lenhard Pennig, Marc Schlamann, Georg Bohner, Thomas Liebig, Bernd Turowski, Franziska Dorn, Cornelius Deuschl, Martin Wiesmann, Markus A. Möhlenbruch, Christoph Kabbasch
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Summary:Background This multicenter study evaluated the safety and efficacy of coated flow diverters (cFDs) for the treatment of ruptured intracranial aneurysms. - Methods Consecutive patients treated with different cFDs for ruptured aneurysms under tirofiban at eight neurovascular centers between 2016 and 2023 were retrospectively analyzed. The majority of patients were loaded with dual antiplatelet therapy after the treatment. Aneurysm occlusion was determined using the O'Kelly-Marotta (OKM) grading scale. Primary outcome measures were major procedural complications and aneurysmal rebleeding during hospitalization. - Results The study included 60 aneurysms (posterior circulation: 28 (47%)) with a mean size of 5.8±4.7 mm. Aneurysm morphology was saccular in 28 (47%), blister-like in 12 (20%), dissecting in 13 (22%), and fusiform in 7 (12%). Technical success was 100% with a mean of 1.1 cFDs implanted per aneurysm. Adjunctive coiling was performed in 11 (18%) aneurysms. Immediate contrast retention was observed in 45 (75%) aneurysms. There was 1 (2%) major procedural complication (a major stroke, eventually leading to death) and no aneurysmal rebleeding. A good outcome (modified Rankin Scale 0-2) was achieved in 40 (67%) patients. At a mean follow-up of 6 months, 27/34 (79%) aneurysms were completely occluded (OKM D), 3/34 (9%) had an entry remnant (OKM C), and 4/34 (12%) had residual filling (OKM A or B). There was 1 (3%) severe in-stent stenosis during follow-up that was treated with balloon angioplasty. - Conclusions Treatment of ruptured aneurysms with cFDs was reasonably safe and efficient and thus represents a valid treatment option, especially for complex cases.
Item Description:Gesehen am 27.09.2024
Physical Description:Online Resource
ISSN:1759-8486
DOI:10.1136/jnis-2024-021516

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