Short-term therapeutic effect of flow diverter on small unruptured intracranial aneurysms

Objective To summarize the short-term therapeutic effect and safety of flow diverter (FD) in the treatment of small unruptured intracranial aneurysms. Methods From April 2014 to March 2019, clinical data were collected from 110 patients with 145 small (diameter < 10 mm) unruptured intracranial aneurysms who were admitted to Department of Neurosurgery, People′s Hospital of Zhengzhou University. Among those, 133 aneurysms were treated with FD alone and 12 aneurysms were treated with FD combined with coiling. Radiological outcomes were assessed based on the Raymond grading. Clinical outcomes were assessed based on the modified Rankin scale score (mRS). Results A total of 121 FD were used for 145 aneurysms. The successful rate of stent implantation was 99% (120/121). For 17 FD, balloon dilatation or massage were performed for better cell opening and wall apposition. There were no hemorrhagic complications. Ischemic complications occurred in 5 cases (4.5%). At 6 months post surgery, DSA results showed that Raymond grade Ⅰ embolism rate was 67.6% (50/74). Asymptomatic stenosis of parent artery was found in 2 cases. The 6-month follow-up results showed the mRS score of 0 in 101 cases, 1 in 4 cases, 2 in 3 cases, and 4 in 1 case and 5 in 1 case. Conclusions Treatment of small unruptured intracranial aneurysms with FD is associated with high success rate and safety. The 6-month follow-up results seem satisfactory and the long-term treatment results still need further follow-up. Key words: Intracranial aneurysm; Treatment outcome; Flow diverter; Unruptured; Small