Comparative safety, efficacy, and predictors of complete occlusion of flow diverter devices in the treatment of unruptured distal anterior cerebral artery aneurysms.
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| Title: | Comparative safety, efficacy, and predictors of complete occlusion of flow diverter devices in the treatment of unruptured distal anterior cerebral artery aneurysms. |
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| 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] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 191675939 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Comparative safety, efficacy, and predictors of complete occlusion of flow diverter devices in the treatment of unruptured distal anterior cerebral artery aneurysms. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Salim%2C+Hamza+Adel%22">Salim, Hamza Adel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Scarcia%2C+Luca%22">Scarcia, Luca</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Clarençon%2C+Frédéric%22">Clarençon, Frédéric</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hajjeh%2C+Orabi%22">Hajjeh, Orabi</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Daraghma%2C+Motaz%22">Daraghma, Motaz</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Simonato%2C+Davide%22">Simonato, Davide</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Li%2C+Yan-Lin%22">Li, Yan-Lin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Shotar%2C+Eimad%22">Shotar, Eimad</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Premat%2C+Kevin%22">Premat, Kevin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jabbour%2C+Pascal%22">Jabbour, Pascal</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tjoumakaris%2C+Stavropoula+I%2E%22">Tjoumakaris, Stavropoula I.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gooch%2C+Reid+M%2E%22">Gooch, Reid M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Psychogios%2C+Marios%22">Psychogios, Marios</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ntoulias%2C+Nikos%22">Ntoulias, Nikos</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sporns%2C+Peter%22">Sporns, Peter</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Puri%2C+Ajit+S%2E%22">Puri, Ajit S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Singh%2C+Jasmeet%22">Singh, Jasmeet</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kuhn%2C+Anna+Luisa%22">Kuhn, Anna Luisa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hassan%2C+Ameer+E%2E%22">Hassan, Ameer E.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Algin%2C+Oktay%22">Algin, Oktay</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Mar2026, Vol. 47 Issue 3, p1-13. 13p. – Name: Abstract Label: Abstract Group: Ab Data: 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] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>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.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s10072-026-08869-w Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 13 StartPage: 1 Titles: – TitleFull: Comparative safety, efficacy, and predictors of complete occlusion of flow diverter devices in the treatment of unruptured distal anterior cerebral artery aneurysms. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Salim, Hamza Adel – PersonEntity: Name: NameFull: Scarcia, Luca – PersonEntity: Name: NameFull: Clarençon, Frédéric – PersonEntity: Name: NameFull: Hajjeh, Orabi – PersonEntity: Name: NameFull: Daraghma, Motaz – PersonEntity: Name: NameFull: Simonato, Davide – PersonEntity: Name: NameFull: Li, Yan-Lin – PersonEntity: Name: NameFull: Shotar, Eimad – PersonEntity: Name: NameFull: Premat, Kevin – PersonEntity: Name: NameFull: Jabbour, Pascal – PersonEntity: Name: NameFull: Tjoumakaris, Stavropoula I. – PersonEntity: Name: NameFull: Gooch, Reid M. – PersonEntity: Name: NameFull: Psychogios, Marios – PersonEntity: Name: NameFull: Ntoulias, Nikos – PersonEntity: Name: NameFull: Sporns, Peter – PersonEntity: Name: NameFull: Puri, Ajit S. – PersonEntity: Name: NameFull: Singh, Jasmeet – PersonEntity: Name: NameFull: Kuhn, Anna Luisa – PersonEntity: Name: NameFull: Hassan, Ameer E. – PersonEntity: Name: NameFull: Algin, Oktay IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 03 Text: Mar2026 Type: published Y: 2026 Identifiers: – Type: issn-print Value: 15901874 Numbering: – Type: volume Value: 47 – Type: issue Value: 3 Titles: – TitleFull: Neurological Sciences Type: main |
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