ABSTRACT NUMBER: ESOC2026LB164 LOW PROFILE FLOW-DIVERTERS FOR INTRACRANIAL ANEURYSM BEYOND THE CIRCLE OF WILLIS

Abstract Background and aims Flow divertion (FD) is the efficacious therapy for large and giant aneurysms of ICA, but data on the FD safety and effectiveness for aneurysms in more distal locations remain contradictory. Aim evaluate the effectiveness and safety of treating cerebral aneurysm beyond of the circle of Willis with low profile flow diverter. Methods 28 patients with 29 intracranial aneurysms beyond the circle of Willis between January 2021 and December 2025. Patients were between 11 and 64 years old have undergone operations for implantation of the low profile flow diverters Pipeline Vantage, FredX, Silk Vista Baby and P48 for the treatment of aneurysms beyond of the circle of Willis. Preoperation 3D modeling was always performed in the PreSize or/and Sim&Size Software. Postoperative control was performed immediately after implantation using a complex of cone beam CT programs of the angiographic systems. After 3 and 6 months a control examination of patients was performed with DSA and MRI. Results In 16 cases the aneurysms were located on MCA, 5 - on ACA, 7 cases - on PCA. Preoperative simulation allowed to select FD optimal size. FD deployment was technically successful in all cases. In 3 cases new small ischemic foci (10,7%) were detected postoperatively. There were no hemorrhagic complications. Follow-up examinations confirmed completely occluded with arterial patency preserved in all cases. 26 patients presented with mRS of 0, 2 patient – mRS of 1 on the 90 days. Conclusions Low-profile flow diverters for the treatment of intracranial aneurysms beyond the circle of Willis is effective and safe. Conflict of interest