Experience with the use of flow diverters in patients with arterial aneurysms in small vesseles

Objective ‒ to evaluate the results of treatment of patients with arterial aneurysms in small vesseles with flow diverters.Materials and methods. 18 patients with arterial aneurysms in small vesseles were treated in SO «Scientific-Practical Center of Endovascular Neuroradiology NAMS of Ukraine» with flow diverters. There were 10 women, 8 men. The average age was 51 years. A total of 20 with flow diverters were implanted. The main criterion for involving patients in the study are patients with arterial aneurysms, which were located on arteries whose diameter was ≤3 mm, and the method of choice for treatment was the implantation of a flow diverter. The diameters of the arteries where the flow diverters were implanted ranged from 1.2 mm to 3 mm. In the acute period of aneurysmal hemorrhage, flow diverters were implanted in 2 patients.Results. the evaluation of the treatment results was carried out thanks to angiographic control, which was carried out 6 months after the implantation flow diverters. At the moment, 16 patients have passed the control examination. 15 patients underwent cerebral angiography according to Seldinger and one ‒ CT angiography. Aneurysm occlusion was assessed using the O’Kelly‒Marotta grading scale: 5 patients – A1, 1 patient – A3, 5 patients – D1, 3 patients – C2, 1 patient with stent thrombosis in the early postoperative period. There were no intraoperative complications during implantation of flow diverters. In one patient, thrombosis of three implanted stent-in-stent Pipeline stents occurred in the M1 segment of the left middle cerebral artery, mRS 90 days – 5. In another case, migration of the proximal end of the stent was noted on the control subject, which was not accompanied by any complications.Conclusions. the use of flow diverters in patients with aneurysms of small diameter vessels is a safe method of treatment, and can be used both initially and in patients with recurrences of previously operated aneurysms.