Abstract
E-265 Determinants of clinical, functional and angiographic outcomes of posterior circulation aneurysms treated with flow diversion: a multicenter experience
Journal of neurointerventional surgery, Vol.16(Suppl 1), pp.A248-A248
07/21/2024
DOI: 10.1136/jnis-2024-SNIS.370
Abstract
IntroductionThe use of flow diversion (FD) for posterior circulation intracranial aneurysms (IAs) has expanded over the years. The study aimed to evaluate determinants of angiographic outcomes (complete IA aneurysm occlusion) and functional and safety outcomes at last follow-up for posterior circulation IAs treated with FD.MethodsData was obtained from the multicentric observational retrospective North American registry for posterior circulation aneurysms treated with FD (Post-FD). This registry included all consecutive patients treated with FD for posterior circulation aneurysms at 10 academic institutions between May 2014 and November 2022. All unruptured and ruptured saccular, fusiform, or dissecting aneurysms in the posterior circulation were included in this study. Univariable and multivariable mixed effects models were used to find determinants of complete occlusion, functional independence (modified Rankin Scale 0–2) and composite safety outcome (major ischemic/hemorrhagic stroke and/or procedure related mortality).ResultsThis study included 198 patients and IAs (median age 58 years, IQR 49–66; male to female ratio 1:1.2). Determinants of complete occlusion included increased age (aOR: 0.97, 95% CI: 0.95 - 0.99, p=0.042), basilar location (aOR: 0.23, 95% CI: 0.10 - 0.56, p=0.001), bifurcation position (aOR: 0.27, 95% CI: 0.08 - 0.91, p=0.034) and increased IAs size (aOR: 0.97, 95% CI: 0.93 - 0.99, p=0.047). Having functional independence at baseline (aOR: 15.86, 95% CI: 3.85 - 65.28, p<0.001) and lower IAs size (aOR: 0.96, 95% CI: 0.93 - 0.99, p=0.017) were associated with higher chances of functional independence. Basilar IAs (OR: 4.01, 95% CI: 1.48 - 10.90, p=0.006) and the number of implanted FD with more >1 implanted FD (OR: 3.18, 95% CI: 1.15 - 8.81, p=0.026) were significantly associated with more rates of composite safety outcome.ConclusionOur results shed light on the important determinants of outcomes including age, IAs’ location, position and size, and number of implanted FD. We urge for careful selection of IAs for FD implantation to obtain optimum outcomes.Disclosures M. Dibas: None. A. Rodriguez-Calienes: None. J. Vivanco-Suarez: None. G. Cortez: None. V. Pereira: 2; C; Stryker, Medtronic, Penumbra, Neurovasc, and Balt. H. Nishi: None. G. Toth: 2; C; Medtronic and Dynamed. T. Patterson: None. D. Altschul: 2; C; Microvention, Stryker, and Von Vascular Inc. C. Feigen: None. M. Essibayi: None. M. Galecio-Castillo: None. J. Fifi: 1; C; Viz. Investor/Stoker: Imperative care and Cerebrotech. 2; C; Penumbra, Stryker, Microvention, and Cerenovus. S. Matsoukas: None. P. Kan: 1; C; NIH, Siemens, Joe Niekro, and Medtronic. 2; C; Stryker, Imperative Care, Cerenovus, and Microvention. M. Hafeez: None. A. Puri: 1; C; Medtronic, Stryker, and Cerenovus. 2; C; Medtronic, Stryker, Cerenovus, Microvention, Agile, Merit, Corindus, Q’apel, Arsenal, and Imperative Care. A. Kuhn: None. A. Wakhloo: None. M. Rabinovich: None. P. Khandelwal: 2; C; Stryker and Medtronic. E. Sauvageau: None. A. Aghaebrahim: None. M. Costa: None. S. Monteith: None. R. Hanel: 1; C; NIH, Interline Endowment, Microvention, Stryker, and CNX. Investor/Stoker: InNeuroCo, Cerebrotech, eLum, Endostream, Three Rivers Medical Inc., Scientia, RisT, BlinkTBI, and Corindus. 2; C; Medtronic, Stryker, Cerenovous, Microvention, Balt, Phenox, Rapid Medical, and Q’Apel. 6; C; MiVI, eLum, Three Rivers Medical Inc., Shape Medical, and Corindus. S. Ortega-Gutierrez: 1; C; NIH-NINDS (R01NS127114–01, RO3NS126804–01), Stryker, Medtronic, Microvention, Methinks, Viz.ai. 2; C; Medtronic, Stryker Neurovascular.
Details
- Title: Subtitle
- E-265 Determinants of clinical, functional and angiographic outcomes of posterior circulation aneurysms treated with flow diversion: a multicenter experience
- Creators
- M Dibas - University of IowaA Rodriguez-Calienes - Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, IAJ Vivanco-Suarez - University of IowaG Cortez - The Neurological InstituteV Pereira - St. Michael's HospitalH Nishi - St. Michael's HospitalG Toth - Cleveland ClinicT Patterson - Cleveland ClinicD Altschul - Albert Einstein College of MedicineC Feigen - Albert Einstein College of MedicineM Essibayi - Albert Einstein College of MedicineM Galecio-Castillo - Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, IAJ Fifi - Mount Sinai Health SystemS Matsoukas - Mount Sinai Health SystemP Kan - The University of Texas Medical Branch at GalvestonM Hafeez - The University of Texas Medical Branch at GalvestonA Puri - University of Massachusetts Chan Medical SchoolA Kuhn - University of Massachusetts Chan Medical SchoolA Wakhloo - Lahey Hospital and Medical CenterM Rabinovich - Lahey Hospital and Medical CenterP Khandelwal - Rutgers, The State University of New JerseyE Sauvageau - The Neurological InstituteA Aghaebrahim - The Neurological InstituteM Costa - Department of Neurology, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WAS Monteith - Swedish Medical CenterR Hanel - Department of Neurology, Lyerly Neurosurgery, Jacksonville, FLS Ortega-Gutierrez - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Journal of neurointerventional surgery, Vol.16(Suppl 1), pp.A248-A248
- DOI
- 10.1136/jnis-2024-SNIS.370
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group Ltd
- Language
- English
- Date published
- 07/21/2024
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984688451202771
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