• Christoph J Griessenauer, Ronie L Piske, Carlos E Baccin, Pereira Benedito J A BJA Hospital Beneficência Portuguesa de São Paulo, Hospital Israelita Albert Einstein, São Paulo, Brazil., Arra S Reddy, Ajith J Thomas, Thiago G Abud, and Christopher S Ogilvy.
• Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
• Neurosurgery. 2017 May 1; 80 (5): 726-732.

BackgroundTreatment of ophthalmic segment aneurysms (OSA) remains challenging. Flow diverter stents (FDS) have evolved as a promising endovascular treatment option for aneurysms of the internal carotid artery and are associated with high occlusion rates and a favorable morbidity and mortality profile.ObjectiveTo determine safety and efficacy of FDS for OSA in a large, multicenter cohort.MethodsA retrospective analysis of prospectively maintained databases of 127 consecutive patients harboring 160 OSA treated with FDS was performed. Aneurysms were classified based on location and morphology. Follow-up with digital subtraction angiography (DSA) was performed 6 to 18 months after treatment.ResultsFollow-up DSA was available for 101 (63.1%) aneurysms with a mean follow-up of 18 months. Complete occlusion was observed in 90 aneurysms (89.1%), near-complete occlusion (>95%) in 3 (3%), and incomplete occlusion (<95%) in 8 aneurysms (7.9%). One aneurysm was retreated with another FDS (0.9%). No risk factors for incomplete occlusion were identified. The OA was occluded at the latest follow-up in 6 cases (7.1%). Permanent morbidity occurred in 4 patients (3.1%), and there was no mortality related to the FDS procedure.ConclusionTreatment of OSA with FDS was found to be safe and effective. The retreatment rate was extremely low and aneurysms that occluded did not reanalyze.Copyright © 2016 by the Congress of Neurological Surgeons.

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