Bibliographic Details
| Title: |
Comparative safety, efficacy, and predictors of complete occlusion of flow diverter devices in the treatment of unruptured distal anterior cerebral artery aneurysms. |
| Authors: |
Salim, Hamza Adel (AUTHOR), Scarcia, Luca (AUTHOR), Clarençon, Frédéric (AUTHOR), Hajjeh, Orabi (AUTHOR), Daraghma, Motaz (AUTHOR), Simonato, Davide (AUTHOR), Li, Yan-Lin (AUTHOR), Shotar, Eimad (AUTHOR), Premat, Kevin (AUTHOR), Jabbour, Pascal (AUTHOR), Tjoumakaris, Stavropoula I. (AUTHOR), Gooch, Reid M. (AUTHOR), Psychogios, Marios (AUTHOR), Ntoulias, Nikos (AUTHOR), Sporns, Peter (AUTHOR), Puri, Ajit S. (AUTHOR), Singh, Jasmeet (AUTHOR), Kuhn, Anna Luisa (AUTHOR), Hassan, Ameer E. (AUTHOR), Algin, Oktay (AUTHOR) |
| Source: |
Neurological Sciences. Mar2026, Vol. 47 Issue 3, p1-13. 13p. |
| Abstract: |
Background: Flow diverters (FDs) are increasingly used for cerebral aneurysms, including distal anterior cerebral artery (DACA) aneurysms, but comparative data between devices in this challenging location are limited. Objective: To compare the safety and efficacy of Pipeline, Silk Vista Baby (SVB), and FRED Jr. FDs for unruptured DACA aneurysms and identify predictors of complete occlusion. Methods: We retrospectively analyzed 166 patients treated with FDs at 39 centers in 14 countries (2018–2022) from the CRETA registry. Outcomes included aneurysm occlusion (O’Kelly–Marotta [OKM] scale), complications, retreatment, modified Rankin Scale (mRS) scores, and independent predictors of complete occlusion using multivariable Cox regression. Results: Aneurysms were predominantly saccular and located on the pericallosal artery. Complete occlusion (OKM D) was achieved in 73%, and neck remnants (OKM C) in 12%, with no differences across devices. Ischemic complications occurred in 11% (mostly asymptomatic), hemorrhagic complications in 5%, and in-stent stenosis in 17%. Retreatment was performed in 1.3%. At last follow-up, 98% had mRS ≤ 2. Independent predictors of complete occlusion were female sex (HR 1.85), asymptomatic presentation (HR 1.79), smaller aneurysm neck (HR 0.83/mm), radial access (HR 2.20), and aspirin plus ticagrelor therapy (HR 1.84); device type was not predictive. Conclusion: Pipeline, SVB, and FRED Jr. FDs show similar safety and efficacy for unruptured DACA aneurysms. Complete occlusion is influenced by clinical and procedural factors, supporting individualized device selection. [ABSTRACT FROM AUTHOR] |
|
Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Psychology and Behavioral Sciences Collection |
