Endovascular Treatment of Intracranial Anterior Circulation Aneurysms with Flow Diverters: A Single Centre Experience with Mid- and Long-Term Results

AIM: We report our experience with flow diverter devices in the treatment of intracranial aneurysms arising from the anterior circulation with mid- and long-term follow-up. MATERIAL and METHODS: Seventy-eight aneurysms in 61 patients (range 25-81 years, 13 male, 48 female) were treated with flow diverter devices. Forty (51.3%) aneurysms were treated with a pipeline embolization device (PED), 24 (30.8%) aneurysms were treated with a SILK stent, 12 (15.4%) aneurysms were treated with a flow redirection endoluminal device (FRED) and two aneurysms were treated with a P64 Flow Modulation Device (P64). Angiographic follow-up data at six months and one year were recorded and the occlusion degrees of the aneurysms were evaluated according to the scale developed by Kamran et al. RESULTS: At six-month follow-up, the complete occlusion (grade 4) rate was 60.8% and at one-year this rate had increased to 74.3%. Statistical analysis revealed a significant difference (p=0.002) between six-month and one-year follow-up results but there was no significant association (p=0.531, p=1.000) between aneurysm occlusion rate and aneurysm diameter. Two patients (3.2%) died due to hemorrhagic complications. CONCLUSION: Endovascular treatment of intracranial anterior circulation aneurysms with flow diverters is a safe and effective treatment option. A high rate of stable occlusion is achieved at long-term follow-up.