Non-ischemic cerebral enhancing (NICE) lesions after flow diversion for intracranial aneurysms: a multicenter study.

Autor:	Richter C; Institute of Neuroradiology, Leipzig University Hospital, Leipzig, Germany cindy.richter@medizin.uni-leipzig.de., Möhlenbruch MA; Department of Interventional Neuroradiology, University of Heidelberg, Heidelberg, Germany., Vollherbst DF; Department of Interventional Neuroradiology, University of Heidelberg, Heidelberg, Germany., Taschner CA; Department of Neuroradiology, University of Freiburg Faculty of Medicine, Freiburg, Germany., Elsheikh S; Department of Neuroradiology, University of Freiburg Faculty of Medicine, Freiburg, Germany., Klisch J; Institute of Diagnostic and Interventional Radiology and Neuroradiology, HELIOS Hospital Erfurt, Erfurt, Germany., Lobsien D; Institute of Diagnostic and Interventional Radiology and Neuroradiology, HELIOS Hospital Erfurt, Erfurt, Germany., Bester M; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Ramdani N; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Kaiser DPO; Institute of Neuroradiology, University Hospital Carl Gustav Carus, Dresden, Germany., Gerber JC; Institute of Neuroradiology, University Hospital Carl Gustav Carus, Dresden, Germany., Schob S; Department of Radiology and Neuroradiology, University Hospital Halle, Halle, Germany., Gazis A; Department of Radiology and Neuroradiology, St Georg Hospital, Leipzig, Germany., Smirnov P; Institute of Neuroradiology, Leipzig University Hospital, Leipzig, Germany., Scherlach C; Institute of Neuroradiology, Leipzig University Hospital, Leipzig, Germany., Hoffmann KT; Institute of Neuroradiology, Leipzig University Hospital, Leipzig, Germany., Gawlitza M; Institute of Neuroradiology, Leipzig University Hospital, Leipzig, Germany.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2024 Oct 14; Vol. 16 (11), pp. 1174-1180. Date of Electronic Publication: 2024 Oct 14.
DOI:	10.1136/jnis-2023-021176
Abstrakt:	Background: Non-ischemic cerebral enhancing (NICE) lesions have been reported as a rare complication of various neuroendovascular procedures, but information on their incidence after flow diversion is scant. It is unclear if specific devices or novel coating technologies may impact their occurrence. Methods: We conducted a multicenter study on the incidence of NICE lesions after flow diverter (FD) implantation for cerebral aneurysm treatment. Results: Eight centers identified 15 patients and provided detailed data. The clinical presentation ranged from asymptomatic to hemiplegia and cognitive impairment. The mean time to diagnosis after treatment was 65.1±101.5 days. Five centers disclosed information on all of their 1201 FD procedures during the inclusion period (2015-2022), during which 12 patients were diagnosed with NICE lesions in these institutions-that is, an incidence of 1%. FD coatings did not increase the incidence (6/591 patients (1%) treated with surface-modified FD vs 6/610 patients (1%) treated with bare FD; P=1.00). Significantly increased rates of 3.7% (6 cases in 161 procedures; P<0.01) and 3.3% (5 cases in 153 procedures; P<0.01) were found with stents of two specific product lines. The use of one product line was associated with a significantly lower incidence (0 cases in 499 procedures (0%); P<0.01). Conclusions: Novel stent coatings are not associated with an increased incidence of NICE lesions. The incidence rate of 1% suggests that these lesions may occur more often after flow diversion than after other endovascular treatments. We found a concerning accumulation of NICE lesion cases when FDs from two product families were used. Competing Interests: Competing interests: MG: Consultancy agreements with MicroVention, Balt, phenox. Scientific advisory board of Simq. Part of the clinical event committee in a study on a flow diverter sponsored by MicroVention. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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