Cerebrovascular article of the month
Flow-Diverting Stents for Intracranial Bifurcation Aneurysm Treatment
Treatment of cerebral aneurysm located at vascular bifurcations with flow diverting devices has been linked with questions about the fate of the covered branch and the risk of symptomatic thromboembolic devices. A new article in NEUROSURGERY offers some data.
Dr. Saleme and colleagues analyzed prospectively collected data on a series of 32 patients with 37 aneurysms treated with flow diverters for intracranial aneurysms at bifurcation sites and divided them into 2 groups based on the side branches covered by the stent during treatment. Group A consisted of cases with side branches that supplied brain territories also receiving a direct collateral supply. Group B consisted of cases in which side branches supplied territories without direct collateral supply.
Initially a new permanent neurological deficit was reported in 3 patients (9.4%). At the 6-month follow-up 78.5% of side branches in group A underwent narrowing or occlusion after 6 months, but no new stroke was found on magnetic resonance imaging. The authors concluded that symptomatic thrombosis or stenosis of side branches after flow diverter treatment depend on the extent and type of collateral supply.