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    Flow diverter for endovascular treatment of intracranial mirror segment internal carotid artery aneurysms

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    Authors
    Kuhn, Anna L.
    Kan, Peter
    Srinivasan, Visish
    Rex, David E.
    de Macedo Rodrigues, Katyucia
    Howk, Mary
    Wakhloo, Ajay K.
    Puri, Ajit S.
    UMass Chan Affiliations
    New England Center for Stroke Research
    Department of Radiology
    Document Type
    Journal Article
    Publication Date
    2018-08-06
    Keywords
    Endovascular treatment
    flow diverter
    mirror segment aneurysms
    pipeline embolization device
    Cardiovascular Diseases
    Cardiovascular System
    Equipment and Supplies
    Nervous System Diseases
    Neurology
    Radiology
    Therapeutics
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    https://doi.org/10.1177/1591019918792536
    Abstract
    Background: To evaluate the feasibility and efficacy of the pipeline embolization device in the treatment of unruptured intracranial mirror segment aneurysms. Methods: Out of a total of 338 subjects, 14 were identified harboring a total of 32 internal carotid artery mirror segment aneurysms that were treated with the pipeline embolization device and were consecutively enrolled into our study. We collected data on patient demographics, modified Rankin scale (mRS) at admission, aneurysm characteristics, clinical outcome at discharge, 3-9 and at 12-18 months as well as angiography results at follow-up. Results: Patients' mean age was 52.9 years; baseline mRS was 0 in all subjects. Pipeline embolization device placement was successful in all cases. Post-treatment mRS remained 0 in 13/14 patients. One patient experienced a small intraparenchymal hemorrhage and subarachnoid hemorrhage, associated with a frontoparietal infarction resulting in right upper extremity weakness and aphasia (post-treatment mRS 3). His mRS evaluation remained stable at the 3-9-month follow-up. Three to 9-month follow-up angiography (13/14 subjects) showed complete aneurysm occlusion in 24/30 aneurysms (80%), near complete and partial occlusion in three of 30 (10%) aneurysms each. At the 9-month follow-up, one patient experienced a complete occlusion of the anterior temporal artery branch but did not present with any clinical deficits. No mRS changes were encountered over a median 6-month follow-up period. Mid-term follow-up angiography (12-18 months) available in eight of 14 subjects showed complete aneurysm occlusion in all patients. Mild intimal hyperplasia was observed in one patient. Conclusions: Flow diversion technology can be used for the treatment of unruptured mirror segment aneurysms in selected patients.
    Source

    Interv Neuroradiol. 2018 Aug 6:1591019918792536. doi: 10.1177/1591019918792536. [Epub ahead of print] Link to article on publisher's site

    DOI
    10.1177/1591019918792536
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/48312
    PubMed ID
    30081693
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    ae974a485f413a2113503eed53cd6c53
    10.1177/1591019918792536
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