Treatment of cavernous sinus aneurysms with flow diversion: Results in 44 patients

R. C. Puffer, M. Piano, Giuseppe Lanzino, L. Valvassori, D. F. Kallmes, L. Quilici, H. J. Cloft, E. Boccardi

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

BACKGROUND AND PURPOSE: Aneurysms of the cavernous segment of the ICA are difficult to treat with standard endovascular techniques, and ICA sacrifice achieves a high rate of occlusion but carries an elevated level of surgical complications and risk of de novo aneurysm formation. We report rates of occlusion and treatment-related data in 44 patients with cavernous sinus aneurysms treated with flow diversion. MATERIALS AND METHODS: Patients with cavernous segment aneurysms treated with flow diversion were selected from a prospectively maintained data base of patients from 2009 to the present. Demographic information, treatment indications, number/type of flow diverters placed, outcome, complications (technical or clinical), and clinical/imaging follow-up data were analyzed. RESULTS: Weidentified 44 patients (37 females, 7 males) who had a flow diverter placed for treatment of a cavernous ICA aneurysm (mean age, 57.2; mean aneurysm size, 20.9 mm). The mean number of devices placed per patient was 2.2. At final angiographic follow-up (mean, 10.9 months), 71% had complete occlusion, and of those with incomplete occlusion, 40% had minimal remnants (<3 mm). In symptomatic patients, complete resolution or significant improvement in symptoms was noted in 90% at follow-up. Technical complications (which included, among others, vessel perforation in 4 patients, groin hematoma in 2, and asymptomatic carotid occlusion in 1) occurred in approximately 36% of patients but did not result in any clinical sequelae immediately or at follow-up. CONCLUSIONS: Our series of flow-diversion treatments achieved markedly greater rates of complete occlusion than coiling, with a safety profile that compares favorably with that of carotid sacrifice.

Original languageEnglish (US)
Pages (from-to)948-951
Number of pages4
JournalAmerican Journal of Neuroradiology
Volume39
Issue number5
DOIs
StatePublished - May 2014

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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    Puffer, R. C., Piano, M., Lanzino, G., Valvassori, L., Kallmes, D. F., Quilici, L., Cloft, H. J., & Boccardi, E. (2014). Treatment of cavernous sinus aneurysms with flow diversion: Results in 44 patients. American Journal of Neuroradiology, 39(5), 948-951. https://doi.org/10.3174/ajnr.A3826