Turkish Neurosurgery
Flow Diversion Therapy of Remnant and Recurrent Intracranial Aneurysms Treated Surgically
Erol Akgul1, Hasan Bilen Onan5, Yusuf Can2, Gulhan Ertan2, Cengiz Erol2, Ahmet Cetinkal3, Celal Cinar6, Bahattin Hakyemez7, Altan Yildiz8, Ismail Oran6, Zeki Sekerci4
1Istanbul Medipol University, International School of Medicine, Radiology, Istanbul,
2Istanbul Medipol University, School of Medicine, Radiology, Istanbul,
3Istanbul Medipol University, School of Medicine, Neurosurgery, Istanbul,
4Istanbul Medipol University, International School of Medicine, Neurosurgery, Istanbul,
5Cukurova University, School of Medicine, Radiology, Adana,
6Ege University, School of Medicine, Radiology, Izmir,
7Uludag University, School of Medicine, Radiology, Bursa,
8Mersin University, School of Medicine, Radiology, Mersin,
DOI: 10.5137/1019-5149.JTN.41653-22.2

Aim:The safety and efficacy of flow diverter stents (FDSs) in the treatment of nearly almost any type and location of aneurysms make them a first-choice treatment for aneurysms. In this study, we evaluated the safety and efficacy of FDSs for treating remnant or recurrent intracranial aneurysms treated surgically.Material and Methods:The patients who were treated with FDSs due to remnant or recurrent intracranial aneurysms after microsurgery were included in the study. The patients’ demographics, treatment histories, aneurysm features, complications associated with flow diversion, and neurological and angiographic follow-up findings were evaluated.Results:Twenty patients (eight males) with 20 aneurysms were included in the study. Of 20 aneurysms, 18 (90%) were in the anterior, and two (10%) were in the posterior circulation. The initial treatment methods were clipping in 17 (85%) and wrapping in three (15%) aneurysms. The endovascular procedure was successful in all patients. In three patients (15%), periprocedural and postprocedural complications were encountered. No hemorrhagic complications were detected on cone-beam computed tomography. One patient with a basilary aneurysm died because of brain stem ischemia. The total morbimortality was 5%. The mean length of follow-up was 13.7  7.3 months in 18 patients. The first angiographic follow-up (3–6 months) revealed the complete occlusion in 7 of 11 aneurysms (63.6%). By contrast, 16 aneurysms (94.1%) were occluded at the last angiographic follow-up, one aneurysm (5.9%) was still filling.Conclusion:An FDS seems effective, safe, and extremely attractive in treating remnant and recurrent intracranial aneurysms treated surgically.

Corresponding author : Erol Akgul