Endovascular treatment of wide-necked paraophthalmic aneurysms with flow diverter stent implantation

Year 2021, Volume: 46 Issue: 4, 1666 - 1674, 30.12.2021

Hamit Güzeldağ , Bilen Onan , Ferhat Can Pişkin , Sinan Sözütok

https://doi.org/10.17826/cumj.977944

Abstract

Purpose: The aim of this study was to present early and mid-term clinical results of flow diverter stents used for the treatment of wide-necked paraophthalmic aneurysms.
Materials and Methods: Between January October 2008-January 2020, the data of 87 patients treated with flow diverter stent due to a wide-necked aneurysm located in the paraophthalmic segment of the internal carotid artery were retrospectively analyzed.
Results: In this study, a total of 87 patients, 66 of whom (75.8%) were women, with an average age of 51.1 ± 8 were involved. A total of 100 paraophthalmic segment aneurysms were treated with flow diverter stents. For forty (40%) paraophthalmic segment aneurysms, embolization was performed using a flow diverter stent with coil. All stents were placed in the desired location (technical success 100%). In one patient, death due to intracranial bleeding occurred on the fifth day after treatment (mortality rate: 1.1%). During long-term follow-up, 3 patients developed critical stent stenosis (narrowing of the stent lumen by more than 50%) and required treatment. Patients were followed for an average of 29.8 ± 3 months. In follow-up at 3th-6th moth and after 6th moth, 77 (81.9%) and 88 (92.6%) aneurysms were total occluded.
Conclusion: Flow diverter stent implantation alone or in combination with coil embolization is a safety and effective method for endovascular treatment of paraophthalmic aneurysms.

Keywords

intracranial aneurysm, Paraophthalmic, Flow diverter, Stent, endovascular embolization, Endovascular Treatment.

Geniş boyunlu paraoftalmik anevrizmaların akım çevirici stent implantasyonu ile endovasküler tedavisi

Abstract

Amaç: Bu çalışmada, amacımız geniş boyunlu paraoftalmik anevrizmaların tedavisi için kullanılan akım çevirici stentlerin erken ve orta dönem klinik sonuçlarını sunmak idi.
Gereç ve Yöntem: Hastanemizin girişimsel radyoloji ünitesinde Ekim 2008-Ocak 2020 tarihleri arasında internal karotid arterin paraoftalmik segmentinde yer alan geniş boyunlu anevrizma nedeniyle akım çevirici stent ile tedavi edilen toplam 87 hastanın verileri retrospektif olarak analiz edildi.
Bulgular: Bu çalışmada yaş ortalaması 51,1 ± 8 olan 66’sı (% 75,8) kadın toplam 87 hasta yer aldı. Otuz dört (% 39) hastada birden fazla olmak üzere, toplam 100 paraoftalmik segment yerleşimli anevrizma, akım çevirici stentler ile tedavi edildi. Kırk (% 40) paraoftalmik segment anevrizmanın tedavisi için akım çevirici stente ek olarak koil embolizasyonu da yapıldı. Tüm stentler istenilen lokalizasyona yerleştirildi (Teknik başarı % 100). Bir hastada tedaviden sonra 5. günde intrakraniyal kanama nedeniyle ölüm gerçekleşti (Mortalite oranı: % 1,1). Uzun dönem takiplerde 3 hastada ileri düzeyde (stent lümenin %50 nin üzerinde daralaması) stent stenozu gelişti ve tedavi gerektirdi. Hastalar ortalama 29,8 ± 3 ay takip edildi. Yapılan kontrollerde ilk 3-6. ayda 77 (%81,9) anevrizma ve 6. ay sonrası kontrollerde 88 (%92,6) anevrizma kapalı idi.
Sonuç: Paraoftalmik anevrizmaların endovasküler tedavisinde akım çevirici stent implantasyonu tek başına veya koil embolizasyonu ile birlikte güvenilir ve etkin bir yöntemdir.

Keywords

İntrakraniyal anevrizma, Paraoftalmik, Akım çevirici, Stent, Endovasküler embolizasyon, Endovasküler tedavi.

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