Abstract 109: Flow-Diversion Versus Conventional Endovascular Techniques for Carotid Cavernous Aneurysms

Abstract

Background and Purpose: Several endovascular treatment options are available for cavernous carotid aneurysms (CCA). We compared PED versus conventional endovascular treatment in terms of evolution of mass effect, complications, recurrence and retreatment rate. Methods: One hundred fifty-seven patients harboring 167 CCA were treated using PED placement, coiling, stent assisted coiling (SAC), and carotid vessel destruction (CVD). Procedural complications, angiographic results, and clinical outcomes were analyzed and compared. Results: There were no difference in age, gender, and mean aneurysm size between those treated with PED and those treated with conventional endovascular procedures. The patients treated with PED had a significantly lower proportion of small size aneurysms(15mm (OR=4.27; p=0.003) to be predictors of none improvement in symptoms. The rate of complete occlusion was 81.36% (48/59) for PED, 42.25% (39/71) for SAC, 27.27% (6/22) for coiling and 73.33% (11/15) for CVD. Retreatment was needed in patients with aneurysm size >15 mm (OR=2.67;p=0.037) and those who were not treated with PED (PED: OR = 0.16; p=0.006). The rate of major complications was 6.6% (11/167). Patients that were treated with PED or SAC had 3.84 lower odds to develop complications (OR=0.26 p<0.05). Conclusion: The use of PED should be encouraged, especially in symptomatic patients. We found PED to be associated with less need for future treatment, higher improvement in symptoms rate and lower rate of complications.