Flow Diversion for Intracranial Aneurysms in Patients with Hematologic Disorders

Area of Science:

• Neurology
• Cardiovascular Medicine
• Hematology

Background:

• Flow diverting stents are a primary treatment for intracranial aneurysms (IA).
• Flow diversion (FD) relies on reducing blood flow and endothelialization for aneurysm occlusion.
• Hematologic disorders (HDs) can alter blood dynamics and stent interactions, potentially affecting FD efficacy.

Purpose of the Study:

• To evaluate the outcomes of patients with various hematologic disorders (HDs) undergoing flow diversion (FD) for intracranial aneurysms (IAs).
• To identify potential risks and benefits of FD in patients with specific hematologic conditions.

Main Methods:

• Retrospective chart review of 11 patients with HDs treated with FD for IAs.
• HDs classified as coagulopathies or hemoglobinopathies (e.g., sickle cell disease [SCD]).
• Clinical and radiographic outcomes assessed using O'Kelly-Marotta (OKM) scores.

Main Results:

• 11 patients with 29 IAs treated; 17 aneurysms received FD.
• 2 of 3 patients with SCD experienced post-operative stroke.
• 7 patients achieved complete aneurysm occlusion (8 treated aneurysms) with a mean time to OKM score of 16.8 months.

Conclusions:

• Flow diversion shows potential for IA occlusion in patients with HDs.
• Concerns exist regarding FD use in patients with sickle cell disease (SCD) due to observed complications.
• Treatment strategies for flow diversion in patients with HDs require individualization.