Introduction: Flow diverter devices (FDD) are commonly used for the treatment of intracranial aneurysms. Over the past decade the technological advances in FDD placement have revolutionized the treatment of intracranial aneurysms. Such advances, include new devices with surfaces modifications that reduces thrombogenicity (ex. Pipeline Shield by Medtronic) and modern techniques (ex. Radial artery access) that decrease severe complications. Herein, an analysis of outcomes over a 7-year period with the placement of FDD for intracranial aneurysms is performed.
Methods: All patients with an intracranial aneurysm treated with a FDD at a large quaternary center from 11/1/2014-10/31/21 was retrospectively examined. Primary and secondary outcomes analyzed included 6-month aneurysmal occlusion (via Raymond-Roy), device and/or parent artery stenosis (including trace, moderate, and severe), and strokes. A multivariable logistic regression analysis was performed for outcomes with variables with p-value Results: During the study period 426 patients were treated with a FDD for an intracranial aneurysm. Of those patients, 60% were found to have a Raymond-Roy of one, 1.4% with a stroke, 20% with any stenosis, and no aneurysmal ruptures following treatment. Radial artery access was performed in 26% of patients and 9% were treated with PED Shield. In univariate analysis, PED Shield, radial artery access, aneurysm diameter >9mm, and neck size > 4.7 mm were found to be significant for 6-month stenosis. On multivariable regression analysis only maximus diameter > 9 mm (OR 23.6 95%CI 1.83-750, p = 0.031) was found to be significant for 6-month stenosis. On multivariable regressions analysis no variables were significant for stroke and/or aneurysm occlusion.
Conclusion : Herein, FDD placement for intracranial aneurysms was found to be safe and effective with no ruptures. However, larger aneurysms appear to be associated with increased risk of stenosis.
