Journal article
Flow Diverter Performance for the Treatment of Intracranial Aneurysms: An International Multicenter Comparative Study
Stroke: Vascular and Interventional Neurology, Vol.3(2), e000696
03/2023
DOI: 10.1161/SVIN.122.000696
Abstract
BACKGROUND Current evidence comparing flow diverters (FDs) for the treatment of intracranial aneurysms is limited to single‐arm head‐to‐head retrospective and prospective studies. Herein, we aimed to compare the efficacy and safety of four FDs for the treatment of intracranial aneurysms. METHODS We performed a retrospective, multicenter international cohort study of adult patients treated with FDs (Pipeline embolization device, Surpass Streamline, Flow Redirection Endoluminal Device, and Silk) for intracranial aneurysms between 2015 and 2021. Efficacy was determined by aneurysm occlusion at final follow‐up. Safety was determined by ischemic/hemorrhagic events and mortality. Secondary safety was assessed by technical complications. A mixed‐effect multivariable ordinal and logistic regression were performed to evaluate variables that predicted the outcomes of interest. RESULTS We included 235 patients with 274 aneurysms. Treatment was performed with either the Pipeline embolization device (92), Surpass Streamline (56), Flow Redirection Endoluminal Device (47), and Silk (40). Median age was 57 (47–65) years. Most patients were asymptomatic (76%), and 8% had previous rupture. Most aneurysms were saccular (85%) and anterior (94%). The Pipeline embolization device subgroup had the largest aneurysms (6 mm, P =0.005). Median follow‐up time was 9 (6–14) months. Final overall complete occlusion was 72% without significant differences between FDs ( P =0.5). Total ischemic (5%) and hemorrhagic (3%) events were also similar ( P =0.1 and P =0.06). One patient expired (0.4%, P =0.6). In multivariable analysis, device diameter predicted aneurysm persistence and ≥50% in‐stent stenosis predicted ischemic/hemorrhagic complications. CONCLUSIONS Our findings comparing 4commonly used FDs in a heterogeneous population with mainly small‐sized aneurysms confirmed a similar safety and efficacy profile between devices.
Details
- Title: Subtitle
- Flow Diverter Performance for the Treatment of Intracranial Aneurysms: An International Multicenter Comparative Study
- Creators
- Juan Vivanco‐Suarez - University of IowaJuan E. Basilio Flores - Universidad MayorAaron Rodriguez‐Calienes - Department of Neurology Neurosurgery & Radiology, University of Iowa Hospitals and Clinics, Iowa City Iowa, Neuroscience, Clinical Effectiveness and Public Health Research Group Universidad Científica del Sur Lima PeruJuan Carlos Miranda - Department of Neuroradiology Sanatorio Sagrado Corazon Buenos Aires ArgentinaGustavo Foa - Department of Neuroradiology Instituto Oulton Cordoba ArgentinaDavid Altschul - Montefiore Medical CenterJoel A. Aguilar‐Melgar - Universidad MayorAndres Dajles - University of IowaMilagros Galecio‐Castillo - Department of Neurology Neurosurgery & Radiology, University of Iowa Hospitals and Clinics, Iowa City IowaCynthia B. Zevallos - University of IowaMudassir Farooqui - University of IowaAjit S. Puri - University of Massachusetts Chan Medical SchoolHenry Pacheco Fernandez Baca - Department of Neurosurgery Hospital Nacional Daniel Alcides Carrion Callao PeruSantiago Ortega‐Gutierrez - Department of Neurology Neurosurgery & Radiology, University of Iowa Hospitals and Clinics, Iowa City Iowa
- Resource Type
- Journal article
- Publication Details
- Stroke: Vascular and Interventional Neurology, Vol.3(2), e000696
- DOI
- 10.1161/SVIN.122.000696
- ISSN
- 2694-5746
- eISSN
- 2694-5746
- Language
- English
- Electronic publication date
- 12/28/2022
- Date published
- 03/2023
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984354511602771
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