Utility of flow diverters in treatment of acutely ruptured uncoilable aneurysms of the posterior circulation of the brain

Basit Öğe Kaydı
dc.authoridSayin, Bige/0000-0003-2824-5942
dc.authoridBatur, Halitcan/0000-0002-4743-7926
dc.contributor.authorBatur, Halitcan
dc.contributor.authorLynch, Jeremy
dc.contributor.authorSayin, Bige
dc.contributor.authorDerakhshani, Shahram
dc.contributor.authorAkmangit, Ilkay
dc.contributor.authorDaglioglu, Ergun
dc.contributor.authorArat, Anil
dc.date.accessioned2024-11-07T13:34:16Z
dc.date.available2024-11-07T13:34:16Z
dc.date.issued2023
dc.departmentNiğde Ömer Halisdemir Üniversitesi
dc.description.abstractPurposeAim of this study is to evaluate safety and efficacy of flow diverters (FDs) in treatment of acutely ruptured posterior circulation aneurysmsMaterials and methodsDatabases of three participating institutions were retrospectively scanned for patients in whom FD placement was attempted for treatment of acutely ruptured vertebrobasilar aneurysms. An interval of 14 days or fewer between the latest ictus and treatment was used as inclusion criterion. Patients with dolichoectasia of vertebrobasilar arteries were excluded. If necessary, adjunctive techniques including coiling or stenting were utilized. Clinical outcomes were graded using mWFNS (modified World Federation of Neurosurgical Societies Scale) and mRS (modified Rankin Scale). Aneurysmal occlusion was defined as Raymond-Roy Class 1. Spearman's (rho) test was used to assess the correlation between variables. Univariate and multivariate logistic regression were used to assess outcomes.Results31 patients (25 women, mean age: 52.7 +/- 15.2) harboring 32 aneurysms (16 non-saccular, mean size: 11.4 +/- 7 mm) were included. Mean number of FDs used was 1.22 +/- 0.42. In six cases, adjunctive coiling and in five cases, apposing stent placement were used. Overall mortality rate and procedure-related mortality rates were 22.5% (7/31) and 9.6% (3/31), respectively. At a mean imaging follow-up of 17.2 +/- 12.6 months, total occlusion was achieved in 22 aneurysms (91.6%). Univariate analysis showed that mortality was positively correlated with vasospasm (rho = 0.600, p < 0.05), higher mWFNS Scale (rho = 0.685, p < 0.05), higher modified Fischer Score (rho = 0.609, p < 0.05), higher mRS (rho = 0.594, p < 0.05) on admission and negatively correlated with saccular morphology (rho = -0.529, p < 0.05). Multivariate logistic regression identified mWFNS on admission as a significant predictor. (OR: 7.148, 95% CI 1.777-28.758, p: 0.01). Adjunctive coiling positively correlated with aneurysm occlusion. (rho = 0.522, p < 0.05).ConclusionThe procedure-related morbidity and mortality is not negligible. However, the risks and efficacy associated with FDs are acceptable, especially when adjunctive coiling is possible, given the lack of treatment alternatives.
dc.identifier.doi10.1007/s11604-023-01409-y
dc.identifier.endpage899
dc.identifier.issn1867-1071
dc.identifier.issn1867-108X
dc.identifier.issue8
dc.identifier.pmid36920731
dc.identifier.scopus2-s2.0-85149976158
dc.identifier.scopusqualityQ2
dc.identifier.startpage889
dc.identifier.urihttps://doi.org/10.1007/s11604-023-01409-y
dc.identifier.urihttps://hdl.handle.net/11480/15889
dc.identifier.volume41
dc.identifier.wosWOS:000950019000001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofJapanese Journal of Radiology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_20241106
dc.subjectAneurysms
dc.subjectHemorrhage
dc.subjectEmbolization
dc.subjectFlow diversion
dc.titleUtility of flow diverters in treatment of acutely ruptured uncoilable aneurysms of the posterior circulation of the brain
dc.typeArticle

Dosyalar

Koleksiyon

WoS İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayın Koleksiyonu
Scopus İndeksli Yayınlar Koleksiyonu