Flow diverter stent for the treatment of ruptured distal anterior cerebral artery: A retrospective multicenter analysis from CRETA registry

BackgroundData on off-label use of flow diverter for ruptured distal anterior cerebral artery aneurysms (rDACAAs) are limited. The purpose of the present study is to evaluate the efficacy and safety of flow diversion for rDACAAs in a large multicenter cohort.MethodsA retrospective observational study on consecutive patients who were treated with flow diversion for rDACAAs at 8 centers in 4 countries was performed. Primary outcome was the occlusion rate of the target aneurysm at the last radiological follow-up. Secondary outcomes included good clinical outcome, retreatment, technical success, procedure-related complications, radiological outcome of the covered branches and mortality rate.ResultsA total of 21 patients with 21 rDACAAs were treated between January 2017 and December 2024. Thirteen patients were women (61.9%) and the median age was 54 years (IQR 46-66). The most common etiology was saccular (71.4%), followed by dissecting (23.8%) and mycotic (4.8%). In all patients a single stent was successful deployed. Median imaging follow-up was 9 (7-12) months. At last follow-up adequate occlusion was 95.2%. Symptomatic thromboembolic or hemorrhagic complications occurred in 9.5% of patients. Seventeen patients (81%) had good clinical outcome (mRS 0-2) with mortality rate of 9.5%. In-stent stenosis occurred in one case that was conservatively managed without major concerns.ConclusionsFlow diversion is feasible as a potential treatment strategy for acutely ruptured aneurysms arising from distal anterior cerebral artery. Flow diverter may represent a valid option whenever other treatments are considered challenging or high risk.

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Journal
Interventional Neuroradiology
Published
2025-08-04
DOI
https://doi.org/10.1177/15910199251348514
Citations
1
Primary Topic
Intracranial Aneurysms: Treatment and Complications
Type
article
Field-Weighted Citation Impact
1.39
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article

Flow diverter stent for the treatment of ruptured distal anterior cerebral artery: A retrospective multicenter analysis from CRETA registry

Riccardo Russo, Eytan Raz, Giancarlo Salsano, Maurizio Fuschi et al.
1 citations
Interventional Neuroradiology
Intracranial Aneurysms: Treatment and Complications
1.39
article

Flow diverter stent for the treatment of ruptured distal anterior cerebral artery: A retrospective multicenter analysis from CRETA registry

Riccardo Russo, Eytan Raz, Giancarlo Salsano, Maurizio Fuschi, Luca Scarcia, Alessandro Pedicelli, Davide Simonato, Charlotte Y. Chung, Matias Sinisalo, Claudia Rollo, Adam Andrew Dmytriw, Sergio Lucio Vinci, Riitta Rautio, Lucio Castellan, Mauro Bergui, Andrea Maria Alexandre, Mariangela Piano, Eimad Shotar, Antonio Armando Caragliano, Vitor Mendes Pereira, Frédéric Clarençon
article en
1 citations

Abstract

BackgroundData on off-label use of flow diverter for ruptured distal anterior cerebral artery aneurysms (rDACAAs) are limited. The purpose of the present study is to evaluate the efficacy and safety of flow diversion for rDACAAs in a large multicenter cohort.MethodsA retrospective observational study on consecutive patients who were treated with flow diversion for rDACAAs at 8 centers in 4 countries was performed. Primary outcome was the occlusion rate of the target aneurysm at the last radiological follow-up. Secondary outcomes included good clinical outcome, retreatment, technical success, procedure-related complications, radiological outcome of the covered branches and mortality rate.ResultsA total of 21 patients with 21 rDACAAs were treated between January 2017 and December 2024. Thirteen patients were women (61.9%) and the median age was 54 years (IQR 46-66). The most common etiology was saccular (71.4%), followed by dissecting (23.8%) and mycotic (4.8%). In all patients a single stent was successful deployed. Median imaging follow-up was 9 (7-12) months. At last follow-up adequate occlusion was 95.2%. Symptomatic thromboembolic or hemorrhagic complications occurred in 9.5% of patients. Seventeen patients (81%) had good clinical outcome (mRS 0-2) with mortality rate of 9.5%. In-stent stenosis occurred in one case that was conservatively managed without major concerns.ConclusionsFlow diversion is feasible as a potential treatment strategy for acutely ruptured aneurysms arising from distal anterior cerebral artery. Flow diverter may represent a valid option whenever other treatments are considered challenging or high risk.

Interventional Neuroradiology
Università Cattolica del Sacro Cuore (IT), Brigham and Women's Hospital (US), St. Michael's Hospital (CA), Turku University Hospital (FI), Agostino Gemelli University Polyclinic (IT), Sorbonne Université (FR), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), NYU Langone Health (US), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Pitié-Salpêtrière Hospital (FR), Hôpitaux Universitaires Henri-Mondor (FR), Azienda Ospedaliera Universitaria Policlinico "G. Martino" (IT), Ospedale Policlinico San Martino (IT), Oxford University Hospitals NHS Trust (GB)
Good health and well-being
Openalex Percentile: Top 17%
Intracranial Aneurysms: Treatment and Complications
1.39
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