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Flow diversion treatment for acutely ruptured aneurysms
Michelle F M Ten Brinck1, Maike Jäger2, Joost de Vries1
1Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Journal of Neurointerventional Surgery
|August 26, 2019
Summary
Flow diverter treatment for ruptured aneurysms carries significant risks, including high complication and re-rupture rates. While effective for aneurysm occlusion, careful patient selection is crucial due to associated poor clinical outcomes.
Area of Science:
- Neurosurgery
- Interventional Neuroradiology
- Vascular Neurology
Background:
- Flow diverters are increasingly used for intracranial aneurysms.
- Limited evidence exists on their safety in acutely ruptured aneurysms.
Purpose of the Study:
- To evaluate complications, clinical, and angiographic outcomes of flow diverter treatment in ruptured intracranial aneurysms.
Main Methods:
- Retrospective observational study of 44 patients treated within 15 days of aneurysm rupture.
- Primary endpoint: good clinical outcome (modified Rankin Scale 0-2).
- Secondary endpoints: procedure-related complications and aneurysm occlusion.
Main Results:
- 45% achieved good clinical outcome; 45% experienced complications, with 27% suffering permanent neurologic deficits.
- Aneurysm re-rupture occurred in 11% (higher in large aneurysms ≥20mm).
- 18% all-cause mortality; 93% complete occlusion at follow-up.
Conclusions:
- Flow diverter treatment for ruptured aneurysms is linked to high complication and re-rupture rates.
- Complications correlate with poor clinical outcomes.
- High occlusion rates are achievable, but risks necessitate careful consideration.
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