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Flow-diverting stents for the treatment of unruptured distal anterior cerebral artery aneurysms: analysis of the CRETA Registry

2024; BMJ; Linguagem: Inglês

10.1136/jnis-2024-022315

1759-8486

Luca Scarcia, Frédéric Clarençon, Adam A. Dmytriw, Eimad Shotar, Kévin Premat, Fadi Al Saiegh, Stavropoula Tjoumakaris, M. Reid Gooch, Marios‐Nikos Psychogios, Nikolaos Ntoulias, Peter B. Sporns, Ajit S Puri, Jasmeet Singh, Anna Luisa Kühn, Ameer E Hassan, Oktay Algın, Markus Möhlenbruch, Sophia Hohenstatt, Riccardo Russo, Mauro Bergui, Oded Goren, Matthew J Kole, Nourou Dine Adeniran Bankole, Richard Bibi, Grégoire Boulouis, Takeshi Morimoto, Fumihiro Sakakibara, Raoul Pop, Ciprian Juravle, Joon Ho, Ángel Ferrario, Virginia Pujol Lereis, Jared Cooper, Chirag D. Gandhi, Giancarlo Salsano, Lucio Castellan, Arianna Camilli, Arturo Consoli, Alessandro Sgreccia, Eytan Raz, Charlotte Chung, Julien Burel, Chrysanthi Papagiannaki, Umair Rasheed, Khawaja Muhammad Baqir Hassan, Tao Hong, Zhe Ji, Riitta Rautio, Matias Sinislao, Maria Ruggiero, Elvis Lafe, Valerio Da Ros, Luigi Bellini, Joseph Gabrieli, Giacomo Cester, Michael R. Levitt, Kate Carroll, Zack Abecassis, Antonio Armando Caragliano, Sergio Lucio Vinci, Guillaume Bellanger, Christophe Cognard, Gaultier Marnat, Lisa Saleille, Nicola Limbucci, Francesco Capasso, Mariangela Piano, Claudia Rollo, Alexis Guédon, Francesco Arpaia, Andrea M. Romi, Fortunato Di Caterino, Alessandra Biondi, Erwah Kalsoum, Vyval Mykola, Adrien Guenego, Aman B. Patel, Vítor Mendes Pereira, Alessandro Pedicelli, Andrea Alexandre,

Cerebrovascular and Carotid Artery Diseases

Background Data about the safety and the efficacy of flow diversion for distal anterior cerebral artery (DACA) aneurysms are limited. We present the largest multicenter analysis evaluating the outcomes of flow diversion in unruptured DACA aneurysm treatment. Methods Databases from 39 centers were retrospectively reviewed for unruptured DACA aneurysms treated with flow-diverting stents. Demographics, clinical presentation, radiographic characteristics, procedural complications, and outcomes were assessed. Results A total of 168 patients with 168 unruptured DACA aneurysms were treated between January 2018 and December 2022. One hundred and twenty-five were women (74.4%) and the median age was 61 (IQR 52–67) years. The most common morphology was saccular (91.7%), with branch involvement in 61.9% of cases. Median parent vessel diameter was 1.9 mm (IQR 1.7–2.2) and stents were successfully deployed in 99.4% of cases. In 96.4% a single stent was implanted, while 3.6% of cases required two stents. Median imaging follow-up was 16.5 (IQR 7–24) months. At last follow-up the rate of occlusion (O’Kelly–Marotta scale C or D) was 82.1%. Symptomatic thromboembolic or hemorrhagic complications occurred in 5.3% of patients and the mortality rate was 0.6%. The rate of retreatment was 1.2%. Conclusions Flow-diverting stents are a reasonably safe and effective treatment option for unruptured DACA aneurysms.