• Dan Lu, Hui Lei, Wei Fang, Naibing Wang, Hu Chen, Guoqiang Luo, Zhenwei Zhao, Tao Zhang, and Jianping Deng.
• Department of Neurosurgery, Xi'an International Medical Center Hospital. Xi'an, China.
• World Neurosurg. 2024 Dec 16: 123568123568.

ObjectiveCurrently, there is no established treatment consensus for craniocervical unruptured dissecting aneurysms (UDAs). This study aimed to assess the safety and efficacy of the Surpass Streamline Flow Diverter (SSFD) for treating craniocervical UDAs.MethodsA retrospective review of three centers' databases was conducted to identify patients with craniocervical UDAs treated with SSFDs from January 2021 to December 2023. Data, including patient and aneurysm characteristics, procedure details, imaging findings, and follow-up data, were analyzed.ResultsThe study included 35 patients with 35 craniocervical UDAs. The mean maximal length of the UDAs was 13.0 ± 6.0 mm, with 57% ranging from 10 to 25 mm. At a mean follow-up of 8.7 ± 2.5 months, the complete occlusion rate was 71% (25/35), with no recurrences detected. Perioperative complications occurred in 3 patients (9%), comprising ischemic stroke in 2 patients (6%) and hemorrhagic stroke in 1 patient (3%). All patients had a good clinical outcome at the 6-month follow-up (mRS < 3). Multivariate logistic regression analysis revealed that aneurysmal dilation with stenosis (OR=0.034, 95% CI: 0.001 - 0.845; p=0.04) was a significant predictive factor for incomplete occlusion of treated aneurysms.ConclusionOur findings suggest that SSFD is a safe and effective tool for craniocervical UDAs, demonstrating a high occlusion rate, acceptable complication rate, and good clinical outcome.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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