Abstract
Abstract WMP25: Flow Diversion: Predictors of Occlusion Rates, Complications, and Long-Term Outcomes in a Large 598 Cohort, a Real-Life Experience
Stroke (1970), Vol.51(Suppl_1)
02/2020
DOI: 10.1161/str.51.suppl_1.WMP25
Abstract
Introduction:
Flow diversion has introduced a paradigm shift in the endovascular field by providing a more physiological approach to treat aneurysms. We aim to assess the efficacy and safety of flow diversion in treating a diverse large cohort of aneurysms with up to 5 years follow up.
Methods:
This is an analysis of a prospectively maintained database at a single-institution. Patients included in the analysis were consecutively treated patients between 2010 and 2019.
Results:
A total of 598 aneurysms were treated during a period extending from 2010-2019 (84.28% females, mean age 55.5 years, av. size 8.49mm). Adequate aneurysm occlusion rates were 63%(376), 73%(436), and 79%(472) at 6 ,12 and 24-month follow-up, respectively. The complete occlusion rate was 75% at a mean duration of 9 months. Of all patients, 8%(48) required retreatment. On multivariate analysis decreasing PED length (0.35,p=0.01), decreasing PED width (0.63,p=0.01), decreasing dome size (0.46,p=0.01), decreased neck width (0.46,p=0.01), absence of wall irregularity (0.60,p=0.01), lack of branching vessel (0.57,p=0.01), and previous treatment (0.56,p=0.05) were independent predictors of aneurysm occlusion.Morbidity rate occurred at a rate of 5.8% and morality at a rate of 2.2%. Ischemic stroke occurred at a rate of 3%. Delayed aneurysmal rupture and distal intraparenchymal hemorrhage occurred at a rate of 3.7%. On multivariate analysis; predictors of stroke were aneurysm size > 15mm. Predictors of DAR/DIPH were increasing aneurysm size, an increasing number of PED used, subjects presenting with a symptomatic aneurysm. Predictors of in-stent stenosis was balloon angioplasty. While increasing age and previous treatment were negatively associated with in-stent stenosis. Predictors of Morbidity were posterior circulation aneurysms, symptomatic presentation, increasing aneurysm size, and hypertension. While, predictors of unfavorable outcome were age > 75, acute SAH, increasing aneurysm size, and posterior circulation aneurysms.
Conclusion:
At a high-volume center with experienced operators, treatment with PED was associated with durable aneurysm occlusion and low risk of complications. The results support the increasing use of flow diverters.
Details
- Title: Subtitle
- Abstract WMP25: Flow Diversion: Predictors of Occlusion Rates, Complications, and Long-Term Outcomes in a Large 598 Cohort, a Real-Life Experience
- Creators
- Ahmad Sweid - Thomas Jefferson UniversityRobert M Starke - University of MiamiNabeel Herial - Thomas Jefferson UniversityNohra Chalouhi - Thomas Jefferson UniversitySomnath Das - Thomas Jefferson UniversityMichael Baldassari - Thomas Jefferson UniversityTyler Alexander - Thomas Jefferson UniversityZubin Hussain - Thomas Jefferson UniversityJulie Kim - Thomas Jefferson UniversitySunidhi Ramesh - Thomas Jefferson UniversityJoshua Weinberg - Thomas Jefferson UniversityFadi Al Saiegh - Thomas Jefferson UniversityNikolaos Mouchtouris - Thomas Jefferson UniversityOmaditya Khanna - Thomas Jefferson UniversityStavropoula Tjoumakaris - Thomas Jefferson UniversityMichael R Gooch - Thomas Jefferson UniversityDavid Hasan - University of IowaRobert Rosenwasser - Thomas Jefferson UniversityPascal M Jabbour - Thomas Jefferson University
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.51(Suppl_1)
- DOI
- 10.1161/str.51.suppl_1.WMP25
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 02/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering
- Record Identifier
- 9984419214302771
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