Flow Diverting Stents in Cerebral Small Caliber Vessels (< 2 mm) for Aneurysm Treatment: A Three Center Retrospective Study

Purpose The off-label use of flow diverting stents (FDS) for treating cerebral aneurysms in small distal vessels is increasing in clinical practice with encouraging results; however, data directly addressing the parent vessel size are still scarce. Our aim was to evaluate the safety and efficacy of...

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Veröffentlicht in:Clinical neuroradiology (Munich) 2023-03, Vol.33 (1), p.99-105
Hauptverfasser: Hohenstatt, Sophia, Vinci, Sergio L., Vollherbst, Dominik F., Tessitore, Agostino, Schmitt, Niclas, Pitrone, Antonio, Caragliano, Antonio A., Velo, Mariano, Möhlenbruch, Markus A., Paolucci, Aldo
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container_issue 1
container_start_page 99
container_title Clinical neuroradiology (Munich)
container_volume 33
creator Hohenstatt, Sophia
Vinci, Sergio L.
Vollherbst, Dominik F.
Tessitore, Agostino
Schmitt, Niclas
Pitrone, Antonio
Caragliano, Antonio A.
Velo, Mariano
Möhlenbruch, Markus A.
Paolucci, Aldo
description Purpose The off-label use of flow diverting stents (FDS) for treating cerebral aneurysms in small distal vessels is increasing in clinical practice with encouraging results; however, data directly addressing the parent vessel size are still scarce. Our aim was to evaluate the safety and efficacy of FDS placement in anterior and posterior circulation aneurysms with parent arteries ≤ 2 mm in a real-world representative setting. Methods We retrospectively reviewed patients treated with FDS at the three participating university hospitals between 2009 and 2021. The inclusion criteria were the placement of at least one FDS in a parent vessel with a maximum diameter of 2 mm or less. The primary clinical safety endpoint was the absence of death, major or minor symptomatic stroke, transient ischemic attack and procedure-related intracranial hemorrhage. Clinical outcome was assessed using the modified Rankin Scale (mRS) score at the follow-up visit at 1 year. The primary efficacy endpoint was defined as complete and near-complete occlusion at the 1‑year follow-up. Results We identified 55 patients harboring 56 aneurysms. The primary clinical safety endpoint was obtained in 93% of cases. The hemorrhagic and thromboembolic complication rates were 4% and 9%, respectively. No patient died or had a relevant discrepancy (> 1 point) at the pre-mRS and post-mRS. The primary efficacy endpoint was reached in 80% of cases. Conclusion The use of FDS in vessels
doi_str_mv 10.1007/s00062-022-01187-6
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Our aim was to evaluate the safety and efficacy of FDS placement in anterior and posterior circulation aneurysms with parent arteries ≤ 2 mm in a real-world representative setting. Methods We retrospectively reviewed patients treated with FDS at the three participating university hospitals between 2009 and 2021. The inclusion criteria were the placement of at least one FDS in a parent vessel with a maximum diameter of 2 mm or less. The primary clinical safety endpoint was the absence of death, major or minor symptomatic stroke, transient ischemic attack and procedure-related intracranial hemorrhage. Clinical outcome was assessed using the modified Rankin Scale (mRS) score at the follow-up visit at 1 year. The primary efficacy endpoint was defined as complete and near-complete occlusion at the 1‑year follow-up. Results We identified 55 patients harboring 56 aneurysms. The primary clinical safety endpoint was obtained in 93% of cases. The hemorrhagic and thromboembolic complication rates were 4% and 9%, respectively. No patient died or had a relevant discrepancy (&gt; 1 point) at the pre-mRS and post-mRS. The primary efficacy endpoint was reached in 80% of cases. Conclusion The use of FDS in vessels &lt; 2 mm is technically feasible with good aneurysm occlusion rates and an acceptable safety profile. Nevertheless, it is essential to be aware of the of the main complications associated when operating in small diameter vessels.</description><identifier>ISSN: 1869-1439</identifier><identifier>EISSN: 1869-1447</identifier><identifier>DOI: 10.1007/s00062-022-01187-6</identifier><identifier>PMID: 35768696</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Embolization, Therapeutic - methods ; Endovascular Procedures - methods ; Humans ; Intracranial Aneurysm - diagnostic imaging ; Intracranial Aneurysm - surgery ; Medicine ; Medicine &amp; Public Health ; Neurology ; Neuroradiology ; Neurosurgery ; Original Article ; Retrospective Studies ; Stents - adverse effects ; Stroke - therapy ; Treatment Outcome</subject><ispartof>Clinical neuroradiology (Munich), 2023-03, Vol.33 (1), p.99-105</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2022</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c298t-58b97f4f88a2bc810e651538485ba5c76d43a7f2baed873ae517947e37d0bea63</cites><orcidid>0000-0002-6163-4328</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00062-022-01187-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00062-022-01187-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35768696$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hohenstatt, Sophia</creatorcontrib><creatorcontrib>Vinci, Sergio L.</creatorcontrib><creatorcontrib>Vollherbst, Dominik F.</creatorcontrib><creatorcontrib>Tessitore, Agostino</creatorcontrib><creatorcontrib>Schmitt, Niclas</creatorcontrib><creatorcontrib>Pitrone, Antonio</creatorcontrib><creatorcontrib>Caragliano, Antonio A.</creatorcontrib><creatorcontrib>Velo, Mariano</creatorcontrib><creatorcontrib>Möhlenbruch, Markus A.</creatorcontrib><creatorcontrib>Paolucci, Aldo</creatorcontrib><title>Flow Diverting Stents in Cerebral Small Caliber Vessels (&lt; 2 mm) for Aneurysm Treatment: A Three Center Retrospective Study</title><title>Clinical neuroradiology (Munich)</title><addtitle>Clin Neuroradiol</addtitle><addtitle>Clin Neuroradiol</addtitle><description>Purpose The off-label use of flow diverting stents (FDS) for treating cerebral aneurysms in small distal vessels is increasing in clinical practice with encouraging results; however, data directly addressing the parent vessel size are still scarce. Our aim was to evaluate the safety and efficacy of FDS placement in anterior and posterior circulation aneurysms with parent arteries ≤ 2 mm in a real-world representative setting. Methods We retrospectively reviewed patients treated with FDS at the three participating university hospitals between 2009 and 2021. The inclusion criteria were the placement of at least one FDS in a parent vessel with a maximum diameter of 2 mm or less. The primary clinical safety endpoint was the absence of death, major or minor symptomatic stroke, transient ischemic attack and procedure-related intracranial hemorrhage. Clinical outcome was assessed using the modified Rankin Scale (mRS) score at the follow-up visit at 1 year. The primary efficacy endpoint was defined as complete and near-complete occlusion at the 1‑year follow-up. Results We identified 55 patients harboring 56 aneurysms. The primary clinical safety endpoint was obtained in 93% of cases. The hemorrhagic and thromboembolic complication rates were 4% and 9%, respectively. No patient died or had a relevant discrepancy (&gt; 1 point) at the pre-mRS and post-mRS. The primary efficacy endpoint was reached in 80% of cases. Conclusion The use of FDS in vessels &lt; 2 mm is technically feasible with good aneurysm occlusion rates and an acceptable safety profile. Nevertheless, it is essential to be aware of the of the main complications associated when operating in small diameter vessels.</description><subject>Embolization, Therapeutic - methods</subject><subject>Endovascular Procedures - methods</subject><subject>Humans</subject><subject>Intracranial Aneurysm - diagnostic imaging</subject><subject>Intracranial Aneurysm - surgery</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Stents - adverse effects</subject><subject>Stroke - therapy</subject><subject>Treatment Outcome</subject><issn>1869-1439</issn><issn>1869-1447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1Kw0AQxxdRbKl9AQ-yRz1E9yP7EfBS6icIHlq9eFg26aRENonuJkpvvpHv5JO4GvXoYZiB-c8P5ofQPiXHlBB1EgghkiWExaJUq0RuoTHVMktomqrtv5lnIzQN4THGCdeZEGoXjbhQMq7lGD1cuPYVn1Uv4LuqWeNFB00XcNXgOXjIvXV4UVvn8Ny6KgeP7yEEcAEfnn68vbNYdX2Ey9bjWQO934QaLz3Yro6YPbRTWhdg-tMn6O7ifDm_Sm5uL6_ns5ukYJnuEqHzTJVpqbVleaEpASmo4DrVIreiUHKVcqtKlltYacUtCKqyVAFXK5KDlXyCDgfuk2-fewidqatQgHO2gbYPhknNlI4_kxhlQ7TwbQgeSvPkq9r6jaHEfHk1g1cTvZpvr-aLf_DD7_MaVn8nvxZjgA-BEFfNGrx5bHvfxJ__w34CtmSEGw</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Hohenstatt, Sophia</creator><creator>Vinci, Sergio L.</creator><creator>Vollherbst, Dominik F.</creator><creator>Tessitore, Agostino</creator><creator>Schmitt, Niclas</creator><creator>Pitrone, Antonio</creator><creator>Caragliano, Antonio A.</creator><creator>Velo, Mariano</creator><creator>Möhlenbruch, Markus A.</creator><creator>Paolucci, Aldo</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6163-4328</orcidid></search><sort><creationdate>20230301</creationdate><title>Flow Diverting Stents in Cerebral Small Caliber Vessels (&lt; 2 mm) for Aneurysm Treatment</title><author>Hohenstatt, Sophia ; Vinci, Sergio L. ; Vollherbst, Dominik F. ; Tessitore, Agostino ; Schmitt, Niclas ; Pitrone, Antonio ; Caragliano, Antonio A. ; Velo, Mariano ; Möhlenbruch, Markus A. ; Paolucci, Aldo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c298t-58b97f4f88a2bc810e651538485ba5c76d43a7f2baed873ae517947e37d0bea63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Embolization, Therapeutic - methods</topic><topic>Endovascular Procedures - methods</topic><topic>Humans</topic><topic>Intracranial Aneurysm - diagnostic imaging</topic><topic>Intracranial Aneurysm - surgery</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Stents - adverse effects</topic><topic>Stroke - therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hohenstatt, Sophia</creatorcontrib><creatorcontrib>Vinci, Sergio L.</creatorcontrib><creatorcontrib>Vollherbst, Dominik F.</creatorcontrib><creatorcontrib>Tessitore, Agostino</creatorcontrib><creatorcontrib>Schmitt, Niclas</creatorcontrib><creatorcontrib>Pitrone, Antonio</creatorcontrib><creatorcontrib>Caragliano, Antonio A.</creatorcontrib><creatorcontrib>Velo, Mariano</creatorcontrib><creatorcontrib>Möhlenbruch, Markus A.</creatorcontrib><creatorcontrib>Paolucci, Aldo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical neuroradiology (Munich)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hohenstatt, Sophia</au><au>Vinci, Sergio L.</au><au>Vollherbst, Dominik F.</au><au>Tessitore, Agostino</au><au>Schmitt, Niclas</au><au>Pitrone, Antonio</au><au>Caragliano, Antonio A.</au><au>Velo, Mariano</au><au>Möhlenbruch, Markus A.</au><au>Paolucci, Aldo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Flow Diverting Stents in Cerebral Small Caliber Vessels (&lt; 2 mm) for Aneurysm Treatment: A Three Center Retrospective Study</atitle><jtitle>Clinical neuroradiology (Munich)</jtitle><stitle>Clin Neuroradiol</stitle><addtitle>Clin Neuroradiol</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>33</volume><issue>1</issue><spage>99</spage><epage>105</epage><pages>99-105</pages><issn>1869-1439</issn><eissn>1869-1447</eissn><abstract>Purpose The off-label use of flow diverting stents (FDS) for treating cerebral aneurysms in small distal vessels is increasing in clinical practice with encouraging results; however, data directly addressing the parent vessel size are still scarce. Our aim was to evaluate the safety and efficacy of FDS placement in anterior and posterior circulation aneurysms with parent arteries ≤ 2 mm in a real-world representative setting. Methods We retrospectively reviewed patients treated with FDS at the three participating university hospitals between 2009 and 2021. The inclusion criteria were the placement of at least one FDS in a parent vessel with a maximum diameter of 2 mm or less. The primary clinical safety endpoint was the absence of death, major or minor symptomatic stroke, transient ischemic attack and procedure-related intracranial hemorrhage. Clinical outcome was assessed using the modified Rankin Scale (mRS) score at the follow-up visit at 1 year. The primary efficacy endpoint was defined as complete and near-complete occlusion at the 1‑year follow-up. Results We identified 55 patients harboring 56 aneurysms. The primary clinical safety endpoint was obtained in 93% of cases. The hemorrhagic and thromboembolic complication rates were 4% and 9%, respectively. No patient died or had a relevant discrepancy (&gt; 1 point) at the pre-mRS and post-mRS. The primary efficacy endpoint was reached in 80% of cases. Conclusion The use of FDS in vessels &lt; 2 mm is technically feasible with good aneurysm occlusion rates and an acceptable safety profile. Nevertheless, it is essential to be aware of the of the main complications associated when operating in small diameter vessels.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35768696</pmid><doi>10.1007/s00062-022-01187-6</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-6163-4328</orcidid></addata></record>
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subjects Embolization, Therapeutic - methods
Endovascular Procedures - methods
Humans
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - surgery
Medicine
Medicine & Public Health
Neurology
Neuroradiology
Neurosurgery
Original Article
Retrospective Studies
Stents - adverse effects
Stroke - therapy
Treatment Outcome
title Flow Diverting Stents in Cerebral Small Caliber Vessels (< 2 mm) for Aneurysm Treatment: A Three Center Retrospective Study
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