• AJNR Am J Neuroradiol · Nov 2014

    The success of flow diversion in large and giant sidewall aneurysms may depend on the size of the defect in the parent artery.

    • J C Gentric, T E Darsaut, A Makoyeva, I Salazkin, and J Raymond.
    • From the Department of Radiology (J.C.G., J.R.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Quebec, Canada Groupe d'étude de la Thrombose en Bretagne Occidentale (J.C.G.), Université de Bretagne Occidentale, Brest, France.
    • AJNR Am J Neuroradiol. 2014 Nov 1; 35 (11): 2119-24.

    Background And PurposeFlow diverters are designed to occlude aneurysms while preserving flow to jailed arterial branches. We postulated that treatment success depended on the size of the aneurysm ostium or defect in the parent artery.Materials And MethodsFlow diverter expansion and deformation were studied in silicone tubes with wall apertures of various sizes. Large and giant canine sidewall aneurysms, featuring a branch located immediately opposite the aneurysm, and a smaller 6- to 8-mm (group A, n = 6) or a larger 10- to 16-mm (group B, n = 6) ostium were created to study the effects of ostium size on aneurysm or branch occlusion by flow diverters. Angiographic results after deployment and at 3 months were scored by using an ordinal scale. The amount of neointima formation on the segment of the device overlying the aneurysm or the branch ostia was determined by specimen photography.ResultsThe fusiform deformation of flow diverters was maximal with larger defects in silicone tubes. At 3 months, group B aneurysms showed worse angiographic results than group A aneurysms, with larger residual aneurysm volumes (P = .002). Neointimal coverage of the aneurysm ostia was more complete in group A compared with group B (P = .002).ConclusionsThe effects of flow diversion may vary with the size of the aneurysm ostium.© 2014 by American Journal of Neuroradiology.

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