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Updated: Aug 25, 2025
18:50
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
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Learning Curve for Flow Diversion of Posterior Circulation Aneurysms: A Long-Term International Multicenter Cohort
N Adeeb1, M Dibas2, C J Griessenauer3,4
1From the Departments of Neurosurgery and Interventional Neuroradiology (N.A., M.D., H.H.C., A.S.A., A.A.), Louisiana State University Hospital, Shreveport, Louisiana nimer_adeeb@hotmail.com.
AJNR. American Journal of Neuroradiology
|October 13, 2022
Summary
Flow diverter treatment for posterior circulation aneurysms is evolving. This study shows a trend toward fewer complications with increased use of single flow diverters over time.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Vascular Surgery
Background:
- Flow diversion is standard for anterior circulation intracranial aneurysms.
- Off-label use for posterior circulation aneurysms is increasing despite concerns.
- Outcomes and complication rates for posterior circulation aneurysms treated with flow diversion require further investigation.
Purpose of the Study:
- To analyze changes in complication rates and treatment outcomes for posterior circulation aneurysms treated with flow diversion over a decade.
- To identify factors influencing these changes and outcomes.
Main Methods:
- Retrospective review of a standardized dataset from multiple international academic institutions.
- Inclusion of patients with ruptured and unruptured posterior circulation aneurysms treated between January 2011 and January 2020.
- Categorization of the study period into four intervals for temporal analysis.
Main Results:
- A total of 378 procedures were analyzed.
- There was an increasing trend in treating vertebral artery aneurysms and a decreasing trend in treating large vertebrobasilar aneurysms.
- A trend towards decreased thromboembolic complications was observed, from 15.8% in 2011-13 to 8.9% in 2018-19.
Conclusions:
- Multicenter experience indicates a shift towards treating fewer basilar aneurysms and smaller aneurysms.
- Increased utilization of single flow diverters per aneurysm was noted.
- These changes correlate with a reduction in thromboembolic and hemorrhagic complication rates.
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