Elective Anterior Communicating Artery Aneurysms Treated with Flow Diverter Stents

Introduction: Anterior communicating aneurysms ( AcomA) are traditionally treated with surgery and embolization with coils or stent coiling.
Our objective is to describe the use of flow diverter stents ( FDS) for elective AcomA treatment.

Methods: A retrospective analysis of consecutive patients with Acom aneurysms electively treated with FDS by a single operator from 2015 to 2022 in two major cerebrovascular centers.

Results: Ten patients had small AcomA treated with FDS. Eight were non ruptured incidental and 2 had a history of subarachnoid hemorrhage (SAH).Six patients were treated with a pipeline and 4 with a Fred FDS. Seven patients had late follow up angiography ( > 6 mo) with complete occlusion (7/7 - 100%).Three (3/10) recent patients are waiting for follow up images.

The overall perioperatory complication rate was 1/10 (10%) with one transitory ischemic neurological deficit due to non compliance to the antiplatelet regimen (Heubner territory ischemia).

Conclusion : Anterior communicating artery aneurysm elective treatment with flow diverter stents was feasible, safe and effective in this small series of cases.