Flow diverter stent for treatment of cerebral aneurysms: A report of 130 patients with 134 aneurysms

Nguyen Thai Binh; Vu Dang Luu; Pham Minh Thong; Nguyen Ngoc Cuong; Nguyen Quang Anh; Tran Anh Tuan; Le Tuan Linh; Nguyen Tat Thien; Md Jamal Uddin; Thien Chu Dinh; Dinh-Toi Chu

doi:10.1016/j.heliyon.2020.e03356

Flow diverter stent for treatment of cerebral aneurysms: A report of 130 patients with 134 aneurysms

Heliyon. 2020 Feb 4;6(2):e03356. doi: 10.1016/j.heliyon.2020.e03356. eCollection 2020 Feb.

Authors

Nguyen Thai Binh^{1

2}, Vu Dang Luu^{2

3}, Pham Minh Thong^{2

3}, Nguyen Ngoc Cuong¹, Nguyen Quang Anh^{2

3}, Tran Anh Tuan³, Le Tuan Linh^{1

2}, Nguyen Tat Thien³, Md Jamal Uddin⁴, Thien Chu Dinh⁵, Dinh-Toi Chu^{6

7}

Affiliations

¹ Radiology Department, Hanoi Medical University Hospital, Hanoi, Viet Nam.
² Hanoi Medical University, Hanoi, Viet Nam.
³ Bach Mai Hospital, Hanoi, Viet Nam.
⁴ College of Pharmacy, Ewha Womans University, Seoul, South Korea.
⁵ Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Viet Nam.
⁶ Hanoi National University of Education, Hanoi, Viet Nam.
⁷ School of Odonto Stomatology, Hanoi Medical University, Hanoi, Viet Nam.

Abstract

Background: This study aims to report our experience with cerebral aneurysms, which may improve in the treatment with the flow-diverter stent and follow up.

Methods: This study was conducted in a consecutive series of 130 patients. 134 procedures were performed for treating these patients in Hanoi Medical University Hospital and Bach Mai Hospital from January 2012 to April 2017. 143 flow diverter stents (Pipeline, FRED and SILK) were used. Aneurysm morphology, stent patency and cerebral parenchyma before and after intervention were analyzed on images of digital subtraction angiography (DSA), computed tomography (CT) and magnetic resonance (MR). The follow-up data after 3-6 months and 12 months were recorded.

Results: In 130 patients (31 men, 99 women), aneurysms of internal carotid artery were mostly common (92.6%), especially in cavernous (35.1%) and in para-ophthalmic (40.3%) segments. 83 cases (61.9%) had wide-neck aneurysms, and 16 cases (11.9%) had multiple aneurysms, and only 5 cases (3.7%) had blister-liked aneurysms. Endovascular treatment was successfully performed at rate of 94.8%. In 3 patients, the stent could not be delivered. Mortality and morbidity rates were 1.5% and 3.7%, respectively. MRI and MSCT follow-up at 3 months showed complete or incomplete occlusions of aneurysms was 7.4% or 17.5%, respectively. 3 patients experienced a thromboembolic event (4.3%).

Conclusions: Intracranial aneurysms of cavernous and para-ophthalmic segments of internal carotid artery are mostly common with wide-neck and multi aneurysms. Deployment of flow diverter stent is safe and effective with high rate of successful and low procedural complications.

Keywords: Alternative medicine; Aneurysms; Cavernous segments; Emergency medicine; Flow diverter stent; Health sciences; Intracranial aneurysms; Neurology; Para-ophthalmic segments; Surgery.