Comparative safety, efficacy, and predictors of complete occlusion of flow diverter devices in the treatment of unruptured distal anterior cerebral artery aneurysms
Background Flow diverters (FDs) are increasingly used for cerebral aneurysms, including distal anterior cerebral artery (DACA) aneurysms, but comparative data between devices in this challenging location are limited. Objective To compare the safety and efficacy of Pipeline, Silk Vista Baby (SVB), an...
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| Hauptverfasser: | , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
18 February 2026
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Neurological sciences
Year: 2026, Jahrgang: 47, Heft: 3, Pages: 1-13 |
| ISSN: | 1590-3478 |
| DOI: | 10.1007/s10072-026-08869-w |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1007/s10072-026-08869-w Verlag, kostenfrei, Volltext: https://www.webofscience.com/api/gateway?GWVersion=2&SrcAuth=GetFTR&SrcApp=WOS&DestURL=https%3A%2F%2Fct.prod.getft.io%2FY2xhcml2YXRlLHNwcmluZ2VyLE1UQXVNVEF3Tnk5ek1UQXdOekl0TURJMkxUQTRPRFk1TFhjLE5UVTRNVGt3TVdZdE9HUmlOaTAwTWpFNExUZ3lNVFF0TVRZNE1EUXpaVEV4TWpBMyxodHRwOi8vbGluay5zcHJpbmdlci5jb20vMTAuMTAwNy9zMTAwNzItMDI2LTA4ODY5LXc_dXRtX3NvdXJjZT1nZXRmdHImdXRtX21lZGl1bT1nZXRmdHImdXRtX2NhbXBhaWduPWdldGZ0cl9waWxvdA.k-Dz41wrDPAazfVP6Ru6fVMROhE6qyLHq8CbJ01uHeo&DestApp=GetFTR&SrcItemId=WOS:001698374600001&SrcAppSID=EUW1ED0AEDpD9ALLb2DzjdETWfF5b&HMAC=EIW9ubCOxjCDqDAUg4j3VZZHwaEi9M%2F8bo8Z7f5X9lM%3D 
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| Verfasserangaben: | Hamza Adel Salim, Luca Scarcia, Frederic Clarencon, Orabi Hajjeh, Motaz Daraghma, Davide Simonato, Yan-Lin Li, Eimad Shotar, Kevin Premat, Pascal Jabbour, Stavropoula I. Tjoumakaris, Reid M. Gooch, Marios Psychogios, Nikos Ntoulias, Peter Sporns, Ajit S. Puri, Jasmeet Singh, Anna Luisa Kuhn, Ameer E. Hassan, Oktay Algin, Markus A. Mohlenbruch, Sophia Hohenstatt, Riccardo Russo, Mauro Bergui, Oded Goren, Matthew J. Kole, Nourou Dine Adeniran Bankole, Richard Bibi, Gregoire Boulouis, Takeshi Morimoto, Fumihiro Sakakibara, Raoul Pop, Ciprian Juravle, Joanna W.K. Ho, Angel Ferrario, Virginia Pujol Lereis, Jared Cooper, Chirag D. Gandhi, Giancarlo Salsano, Lucio Castellan, Arturo Consoli, Alessandro Sgreccia, Eytan Raz, Charlotte Chung, Julien Burel, Chrysanthi Papagiannaki, Umair Rasheed, Khawaja Muhammad Baqir Hassan, Hong Tao, Zhe Ji, Riitta Rautio, Matias Sinisalo, Maria Ruggiero, Elvis Lafe, Valerio Da Ros, Luigi Bellini, Joseph Domenico Gabrieli, Francesco Causin, Michael R. Levitt, Kate Carroll, Zachary Abecassis, Antonio Armando Caragliano, Sergio Lucio Vinci, Guillaume Bellanger, Christophe Cognard, Gaultier Marnat, Lisa Saleille, Nicola Limbucci, Francesco Capasso, Mariangela Piano, Claudia Rollo, Alexis Guedon, Francesco Arpaia, Andrea Romi, Fortunato Di Caterino, Alessandra Biondi, Erwah Kalsoum, Mykola Vyval, Adrien Guenego, Than Nguyen, Mohamad Abdalkader, Thibault Agripnidis, Aman B. Patel, Vitor Mendes Pereira, Maurizio Fuschi, Alessandro Pedicelli, Vivek Yedavalli, Max Wintermark, Andrea M. Alexandre, Adam A. Dmytriw on behalf of the CRETA Investigators |
| Zusammenfassung: | Background Flow diverters (FDs) are increasingly used for cerebral aneurysms, including distal anterior cerebral artery (DACA) aneurysms, but comparative data between devices in this challenging location are limited. Objective To compare the safety and efficacy of Pipeline, Silk Vista Baby (SVB), and FRED Jr. FDs for unruptured DACA aneurysms and identify predictors of complete occlusion. Methods We retrospectively analyzed 166 patients treated with FDs at 39 centers in 14 countries (2018-2022) from the CRETA registry. Outcomes included aneurysm occlusion (O'Kelly-Marotta [OKM] scale), complications, retreatment, modified Rankin Scale (mRS) scores, and independent predictors of complete occlusion using multivariable Cox regression. Results Aneurysms were predominantly saccular and located on the pericallosal artery. Complete occlusion (OKM D) was achieved in 73%, and neck remnants (OKM C) in 12%, with no differences across devices. Ischemic complications occurred in 11% (mostly asymptomatic), hemorrhagic complications in 5%, and in-stent stenosis in 17%. Retreatment was performed in 1.3%. At last follow-up, 98% had mRS <= 2. Independent predictors of complete occlusion were female sex (HR 1.85), asymptomatic presentation (HR 1.79), smaller aneurysm neck (HR 0.83/mm), radial access (HR 2.20), and aspirin plus ticagrelor therapy (HR 1.84); device type was not predictive. Conclusion Pipeline, SVB, and FRED Jr. FDs show similar safety and efficacy for unruptured DACA aneurysms. Complete occlusion is influenced by clinical and procedural factors, supporting individualized device selection. |
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| Beschreibung: | Online veröffentlicht: 18. Februar 2026 Gesehen am 20.04.2026 |
| Beschreibung: | Online Resource |
| ISSN: | 1590-3478 |
| DOI: | 10.1007/s10072-026-08869-w |