Treatment of ruptured intracranial aneurysms with flow diverter devices
EANS Academy. Alpay K. 09/25/19; 275575; EP01045
Dr. Kemal Alpay
Dr. Kemal Alpay

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We report clinical and radiologic outcome of patients with ruptured intracranial aneurysms (RICA) which were treated with implantation of flow diverter devices (FDD) in this single-center series.
Between 2013 and 2018 twenty-six patients with RICAs treated with FDD in our hospital. Eighteen (70%) of twenty-six aneurysms was fusiform. Eight (30%) of twenty-six aneurysm were in the posterior circulation. The average size of the aneurysm was 4,3 mm in maximal diameter (range, 2-10 mm). The group included nineteen females and ten males. The median age was 57 years (range, 30-80 years). Twenty-five patients presented with acute subarachnoid hemorrhage (SAH) detected by unenhanced CT due to RICA and one patient detected by lumbar puncture. The average score of World Federation of Neurosurgical Societies was 2,6. None of the ruptured aneurysms re-bled after endovascular treatment. The clinical follow-up was scheduled after three and twelve months. Clinical outcome was assessed with the Glasgow outcome scale extended (GOSE) after three months. The average GOSE of twenty-five (96%) patients was 5. Four patients (15%) were dead due to complications of SAH during hospital stay. One patient was lost to follow-up. Among survived patients the radiologic follow up of nineteen patients is available. The average radiologic follow-up was fourteen months on average (range, 60-2 months). The radiologic follow-up showed complete occlusion of aneurysm in seventeen patients (90%) and partial occlusion in two patients (10%). The successful implantation of flow diverters was 100%. Only one patient (4%) developed acute in-stent thrombosis.
FDD are safe and effective in terms of radiologic and clinical outcome when other conventional endovascular and surgical therapies are not appropriate.

[Demographic, clinical, and aneurysm characteristics ]

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