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Updated: Aug 19, 2025
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Intracranial aneurysms in pediatric population treated with flow diverters: A single-center experience
Jorge Arturo Santos-Franco1, Carlos Antonio Cruz-Argüelles1, Fernando Agustin-Aguilar1
1Department of Neurosurgery, Hospital de Especialidades, Centro Médico Nacional La Raza, Mexico City, Mexico.
Insights
Flow diverters (FDs) effectively treat selected pediatric intracranial aneurysms (PIAs), showing stable occlusion in 90% of patients over a year. This study highlights FDs as a viable option for these rare pediatric vascular conditions.
Area of Science:
- Neuroendovascular surgery
- Pediatric neurosurgery
- Vascular neurology
Background:
- Pediatric intracranial aneurysms (PIAs) are rare cerebrovascular conditions.
- Flow diverters (FDs) are an emerging endovascular treatment option for aneurysms.
Purpose of the Study:
- To evaluate the safety and efficacy of flow diverters in treating pediatric intracranial aneurysms.
- To assess outcomes and imaging follow-up in pediatric patients treated with FDs.
Main Methods:
- Retrospective case series of 10 pediatric patients treated with FDs.
- Data collected on patient demographics, aneurysm characteristics, treatment, and follow-up.
- Imaging follow-up included CT angiography and DSA at regular intervals.
Main Results:
- 10 pediatric patients (4.3% of total FD-treated patients) with PIAs were treated.
- Presenting symptoms included subarachnoid hemorrhage, epilepsy, cranial nerve compression, and headache.
- 90% of patients achieved stable aneurysm occlusion at a minimum 1-year follow-up.
Conclusions:
- Flow diverters are a potentially effective treatment for carefully selected pediatric intracranial aneurysms.
- This small series demonstrates favorable outcomes with sustained aneurysm occlusion.
Background:
Pediatric intracranial aneurysms (PIAs) are uncommon. Flow diverters (FDs) have shown to be effective on treatment of selected aneurysms.
Methods:
We describe 10 cases of PIAs treated with FDs at one medical center in Mexico, from April 2015 to April 2020.
Results:
Out of 230 patients treated with FDs, 10 (4.3%) were pediatric. Average age was 9.4 years old (R: 6-15). Two patients (20%) had subarachnoid hemorrhage, 3 had epilepsy (30%), 3 (30%) had clinical signs of cranial nerve compression, and 4 (40%) had only headache. Two patients were in 1a grade of Hunt and Kosnik scale. Out of the nonruptured aneurysms, 7 (70%) were in 15 points of Glasgow Coma Scale and 1 patient (10%) was in 13 points. Treatment was performed without complications; nevertheless, appropriate distal deployment was not achieved in one case. At discharge, nine patients had 5 points of Glasgow Outcome Scale. All patients underwent computed tomography angiography or digital subtraction angiography at 1, 3, 6, and 12 months, 2 patients (20%) had a 2-year follow-up, and 3 patients (30%) had a 3-year follow-up. According to Kamran grading scale, 9 patients (90%) were classified as Grade 4 and 1 patient (10%) as Grade 3.
Conclusion:
Even though it is a small series, as this is an uncommon disease, we may suggest that FDs are useful to treat properly selected PIAs. Our study has consecutive imaging assessment at least a year of follow-up in which aneurysm stable occlusion was observed in 90% of patients.
