Progressive volume reduction and long-term aneurysmal collapse following flow diversion treatment of giant and symptomatic cerebral aneurysms
BackgroundThe primary goal of conventional endovascular and microvascular approaches is the clinical and radiological resolution of the symptomatic aneurysm-induced mass effect. This study assessed the volume changes and mass effect reduction due to sac shrinkage after treatment with flow diverter s...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.972599/full |
| _version_ | 1811216852192329728 |
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| author | Kristina Sirakova Marin Penkov Svetozar Matanov Krasimir Minkin Kristian Ninov Asen Hadzhiyanev Vasil Karakostov Irena Ivanova Stanimir Sirakov |
| author_facet | Kristina Sirakova Marin Penkov Svetozar Matanov Krasimir Minkin Kristian Ninov Asen Hadzhiyanev Vasil Karakostov Irena Ivanova Stanimir Sirakov |
| author_sort | Kristina Sirakova |
| collection | DOAJ |
| description | BackgroundThe primary goal of conventional endovascular and microvascular approaches is the clinical and radiological resolution of the symptomatic aneurysm-induced mass effect. This study assessed the volume changes and mass effect reduction due to sac shrinkage after treatment with flow diverter stents (FD) for unruptured cerebral aneurysms.MethodsWe analyzed retrospectively 36 symptomatic aneurysms that were larger or equal to 25 mm in diameter in patients treated at our center from January 2016 to April 2022. Radiological and clinical outcomes were analyzed, including aneurysmal volume changes and resolution of aneurysm-related symptoms.ResultsAt 6 months, 25 aneurysms decreased in size, 2 remained unchanged, and 9 aneurysms demonstrated a post-treatment dimensional increase. At 12 months, 30 aneurysms showed a progressive radiological volume reduction. Either no change or negligible shrinkage was observed in the remaining six aneurysms. At 24 months, 32 aneurysms showed aneurysmal shrinkage by a mean 47% volume loss with respect to baseline. At the last follow-up, all 13 patients who had presented with third cranial nerve palsy showed improvements. Complete reversal of the pretreatment edematous changes was confirmed in all cases. The overall post-treatment complication rate was 8.3%, as 3 patients experienced non-fatal delayed rupture of their aneurysm. There was no mortality in this study.ConclusionFlow diversion could effectively induce progressive aneurysmal shrinkage and resolution of the mass effect associated with giant symptomatic cerebral aneurysms. |
| first_indexed | 2024-04-12T06:45:56Z |
| format | Article |
| id | doaj.art-6611fd3cacbb41fd952a011b7054371e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T06:45:56Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-6611fd3cacbb41fd952a011b7054371e2022-12-22T03:43:34ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-08-011310.3389/fneur.2022.972599972599Progressive volume reduction and long-term aneurysmal collapse following flow diversion treatment of giant and symptomatic cerebral aneurysmsKristina Sirakova0Marin Penkov1Svetozar Matanov2Krasimir Minkin3Kristian Ninov4Asen Hadzhiyanev5Vasil Karakostov6Irena Ivanova7Stanimir Sirakov8Radiology Department, Alexandrovska Hospital, Sofia, BulgariaRadiology Department, University Hospital St Ivan Rilski, Sofia, BulgariaRadiology Department, University Hospital St Ivan Rilski, Sofia, BulgariaNeurosurgery Department, University Hospital St Ivan Rilski, Sofia, BulgariaNeurosurgery Department, University Hospital St Ivan Rilski, Sofia, BulgariaNeurosurgery Department, University Hospital St Ivan Rilski, Sofia, BulgariaNeurosurgery Department, University Hospital St Ivan Rilski, Sofia, BulgariaClinical Laboratory Department, University Hospital St Ivan Rilski, Sofia, BulgariaRadiology Department, University Hospital St Ivan Rilski, Sofia, BulgariaBackgroundThe primary goal of conventional endovascular and microvascular approaches is the clinical and radiological resolution of the symptomatic aneurysm-induced mass effect. This study assessed the volume changes and mass effect reduction due to sac shrinkage after treatment with flow diverter stents (FD) for unruptured cerebral aneurysms.MethodsWe analyzed retrospectively 36 symptomatic aneurysms that were larger or equal to 25 mm in diameter in patients treated at our center from January 2016 to April 2022. Radiological and clinical outcomes were analyzed, including aneurysmal volume changes and resolution of aneurysm-related symptoms.ResultsAt 6 months, 25 aneurysms decreased in size, 2 remained unchanged, and 9 aneurysms demonstrated a post-treatment dimensional increase. At 12 months, 30 aneurysms showed a progressive radiological volume reduction. Either no change or negligible shrinkage was observed in the remaining six aneurysms. At 24 months, 32 aneurysms showed aneurysmal shrinkage by a mean 47% volume loss with respect to baseline. At the last follow-up, all 13 patients who had presented with third cranial nerve palsy showed improvements. Complete reversal of the pretreatment edematous changes was confirmed in all cases. The overall post-treatment complication rate was 8.3%, as 3 patients experienced non-fatal delayed rupture of their aneurysm. There was no mortality in this study.ConclusionFlow diversion could effectively induce progressive aneurysmal shrinkage and resolution of the mass effect associated with giant symptomatic cerebral aneurysms.https://www.frontiersin.org/articles/10.3389/fneur.2022.972599/fullaneurysmflow diversionshrinkageembolizationgiant |
| spellingShingle | Kristina Sirakova Marin Penkov Svetozar Matanov Krasimir Minkin Kristian Ninov Asen Hadzhiyanev Vasil Karakostov Irena Ivanova Stanimir Sirakov Progressive volume reduction and long-term aneurysmal collapse following flow diversion treatment of giant and symptomatic cerebral aneurysms Frontiers in Neurology aneurysm flow diversion shrinkage embolization giant |
| title | Progressive volume reduction and long-term aneurysmal collapse following flow diversion treatment of giant and symptomatic cerebral aneurysms |
| title_full | Progressive volume reduction and long-term aneurysmal collapse following flow diversion treatment of giant and symptomatic cerebral aneurysms |
| title_fullStr | Progressive volume reduction and long-term aneurysmal collapse following flow diversion treatment of giant and symptomatic cerebral aneurysms |
| title_full_unstemmed | Progressive volume reduction and long-term aneurysmal collapse following flow diversion treatment of giant and symptomatic cerebral aneurysms |
| title_short | Progressive volume reduction and long-term aneurysmal collapse following flow diversion treatment of giant and symptomatic cerebral aneurysms |
| title_sort | progressive volume reduction and long term aneurysmal collapse following flow diversion treatment of giant and symptomatic cerebral aneurysms |
| topic | aneurysm flow diversion shrinkage embolization giant |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.972599/full |
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