Flow-Diversion Effect of LEO Stents: Aneurysm Occlusion and Flow Remodeling of Covered Side Branches and Perforators
| Autor: | Matteo Cappucci, Vincent Costalat, G. Gascou, Cyril Dargazanli, Alain Bonafe, F. Cagnazzo, Pierre-Henri Lefevre, V. Mazzotti, C. Riquelme, Riccardo Morganti |
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| Přispěvatelé: | Département de Neuroradiologie[Montpellier], Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM) |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty [SDV]Life Sciences [q-bio] medicine.medical_treatment Vascular Remodeling Asymptomatic Magnetic resonance angiography 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Aneurysm medicine.artery Occlusion Complete occlusion Humans Medicine Radiology Nuclear Medicine and imaging cardiovascular diseases Posterior communicating artery Aged Retrospective Studies Interventional Flow diversion medicine.diagnostic_test business.industry Endovascular Procedures Stent Intracranial Aneurysm Middle Aged medicine.disease Surgery Treatment Outcome Female Stents Neurology (clinical) medicine.symptom business Magnetic Resonance Angiography 030217 neurology & neurosurgery |
| Zdroj: | American Journal of Neuroradiology American Journal of Neuroradiology, American Society of Neuroradiology, 2018, 39 (11), pp.2057--2063. ⟨10.3174/ajnr.A5803⟩ AJNR Am J Neuroradiol |
| ISSN: | 1936-959X 0195-6108 |
| Popis: | International audience; BACKGROUND AND PURPOSE: Flow diversion with intermediate-porosity stents (braided stents) has been recently reported for distally located small aneurysms. The aim of this study was to evaluate the flow-diversion effect of LEO stents on covered vessels and for aneurysms treated with sole stent-placement therapy. MATERIALS AND METHODS: We retrospectively evaluated the following outcomes: 1) remodeling of covered side branches and perforators (extra-aneurysmal flow remodeling), and 2) the occlusion rate of aneurysms treated with sole stent-placement therapy (intra-aneurysmal flow remodeling). RESULTS: Seventy-six patients with 98 covered vessels were studied. Overall, 89 covered arteries (91%) were normal, 7 showed narrowing (7%), and 2 (2%) were occluded (1 posterior communicating artery and 1 MCA) without related complications (mean DSA follow-up, 14 months). Univariate and multivariate analyses highlighted smoking (P = .03) and the length of follow-up (P = .002) as factors associated with arterial remodeling. Of the 17 Sylvian (lenticulostriate arteries) and 7 basilar perforators, 1 (4%) group of Sylvian perforators covered with double stents had asymptomatic remodeling. Ten aneurysms (mean size, 3.5 mm) were treated with LEO stents as stent monotherapy (5 recanalized after coiling and 5 directly treated with the LEO). Complete occlusion (Raymond-Roy I) was achieved in 70% of aneurysms (mean follow-up, 14 months). The Raymond-Roy I occlusion rate among recanalized aneurysms and those directly treated with LEO stents was 80% and 60%, respectively (P = .9). CONCLUSIONS: The rate of flow remodeling on the covered arteries and perforators was 9% and 4%, respectively, and was clinically irrelevant in all cases. Complete occlusion of aneurysms treated with sole stent-placement therapy was 70%. These data stress the flow-diversion properties of LEO stents. |
| Databáze: | OpenAIRE |
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