OUTCOME EVALUATION OF FLOW DIVERTER STENT PLACEMENT IN TREATMENT OF RUPTURED AND UNRUPTURED CEREBRAL ANEURYSMS

Abstract

Background: Cerebral aneurysms affect about 5% of the population and are associated with high mortality rates and severe complications for families and society. Complex aneurysm types include giant aneurysms, wide - necked aneurysms, blister - like aneurysms, recurrent aneurysms, fusiform aneurysms, and multiple aneurysms, which are difficult to manage with conventional endovascular or surgical methods due to complications such as coil migration and high rates of re - rupture. The development of flow diverter stents has been a breakthrough in recent decades and has been demonstrated to be safe and effective in treating aneurysms. The aim of this study was to evaluate the outcomes of flow diverter stent placement in the treatment of ruptured and unruptured cerebral aneurysms. Methods: This was a descriptive prospective study that followed up on 23 patients diagnosed and treated for cerebral aneurysms with flow - diverter stent intervention at the Stroke Department of Hue Central Hospital from 6/2020 to 6/2022. The follow - up data after 6 months and 12 months were recorded. Results: There were 23 patients (9 males, 14 females) with 28 cerebral aneurysms, with a mean age of 51.7 ± 9.9 years. Aneurysms were predominantly located in the anterior circulation (85.7%) and 14.3% in the posterior circulation. The most common aneurysm type was fusiform (75%), followed by dissecting (17.9%) and blister - like (7.1%). Most aneurysms had wide necks, with a neck - to - dome ratio < 1.5, accounting for 82.1%. Flow diverter stent placement was successfully performed in 91.3% of patients, with 27 stents used. Stents were properly positioned, well - expanded in 88.9%. The complication rate after intervention was 4.3%. Complete aneurysm occlusion rates at 6 to 12 months were 92.9% and 96.4%, respectively. The rate of mild in - stent stenosis without clinical symptoms was 4.3%. The good outcome rate (mRS 0 - 2) was 91.3%. Conclusion: Flow diverter stent is effective and safe with high rate of successful and low procedural complications in the treatment of complex cerebral aneurysms.