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Endovascular management of non-ruptured intracranial aneurysms with flow diverter devices. First experience in Peru.

Enviado por admin el Sáb, 08/17/2019 - 20:01
GIANCARLO SAAL-ZAPATA, WALTER DURAND S, RICARDO VALLEJOS T, DANTE VALER G, JESÚS FLORES Q, RODOLFO RODRIGUEZ V.
Tipo: 
Original Article
ABSTRACT (English): 

 

Introduction: Endovascular treatment of non-ruptured intracranial aneurysms with flow diverter devices is a technique that currently has many indications for its use.

Objectives: Determine the clinical characteristics of patients, angiographic characteristics of the aneurysms, occlusion rate at 6 months and 1 year follow-up and complications associated to the deployment of flow diverter devices in the treatment of non-ruptured intracranial aneurysms.

Methods: We present a retrospective review of consecutive cases treated with flow diverters at our institution.

Results: Since October 2012 to April 2017, twenty-one patients were treated with a total of 29 non-ruptured aneurysms. Twenty six aneurysms (90%) were located in the anterior circulation and three aneurysms were located in the posterior circulation (10%). We employed 22 flow diverters (SILK = 9, FRED = 13). Fifty percent of the aneurysms were located in the paraclinoid segment of the internal carotid artery, followed by 28% located in the cavernous segment. 

Globally, fifty eight percent of the patients were cured. There were three patients with persistence of the aneurysms and five complications: three carotid thrombosis, one migration and one mal-apposition of the stent. All this complications were and remain asymptomatic. Mortality rate in this series was zero percent.

Discussion: The use of flow diverter devices is a new technique for the treatment of non-ruptured intracranial aneurysms at our institution, with adequate rates of aneurysm occlusion.

 

     Keywords: Intracranial Aneurysm, Stents, Cerebral Angiography. (source: MeSH NLM)

 

ABSTRACT (Spanish): 

 

Introducción: El tratamiento endovascular de los aneurismas intracraneales no rotos usando diversores de flujo es una técnica que en la actualidad tiene numerosas indicaciones para su uso.
Objetivos: Determinar las características clínicas de los pacientes, las características angiográficas de los aneurismas, la tasa de oclusión a los 6 meses y el 1er año, además de las complicaciones asociadas a la colocación de diversores de flujo en el tratamiento de aneurismas intracraneales no rotos.
Métodos: Presentamos una revisión retrospectiva de los casos consecutivos tratados con diversores de flujo en nuestra institución.
Resultados: Desde octubre 2012 hasta abril 2017 se trataron 21 pacientes con un total de 29 aneurismas intracraneales no rotos, de los cuales 26 aneurismas (90%) fueron del territorio anterior y 3 aneurismas se localizaron en circulación posterior (10%). Utilizamos 22 diversores de flujo (SILK = 9, FRED = 13). El 50% de los aneurismas se localizaron en el segmento paraclinoideo de la carótida interna, seguido del 28% en el segmento cavernoso.
De manera global, el 58% de pacientes se curó, hubo 3 pacientes con persistencia de aneurismas y 5 complicaciones: 3 trombosis carotídeas, 1 stent migrado y 1 stent mal aposicionado, todas asintomáticas. La mortalidad en la serie fue 0%.
Discusión: El uso de diversores de flujo es una técnica segura y efectiva para el tratamiento de aneurismas intracraneales no rotos en nuestra institución.
 
     Palabras Clave: Aneurisma Intracraneal, Stents, Angiografía Cerebral. (fuente: DeCS Bireme)
 
 
Icono PDF Endovascular management of non-ruptured intracranial aneurysms with flow diverter devices ENGLISH.pdf
Icono PDF MANEJO ENDOVASCULAR DE ANEURISMAS INTRACRANEALES NO ROTOS USANDO DIVERSORES DE FLUJO Spanish.pdf