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

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

Research output: Contribution to journalArticle

34 Citations (Scopus)

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 - 2014

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Cavernous Sinus
Aneurysm
Therapeutics
Endovascular Procedures
Groin
Hematoma
Demography
Databases
Safety
Equipment and Supplies

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Puffer, R. C., Piano, M., Lanzino, G., Valvassori, L., Kallmes, D. F., Quilici, L., ... 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

Treatment of cavernous sinus aneurysms with flow diversion : Results in 44 patients. / Puffer, R. C.; Piano, M.; Lanzino, Giuseppe; Valvassori, L.; Kallmes, David F; Quilici, L.; Cloft, H. J.; Boccardi, E.

In: American Journal of Neuroradiology, Vol. 39, No. 5, 2014, p. 948-951.

Research output: Contribution to journalArticle

Puffer, RC, Piano, M, Lanzino, G, Valvassori, L, Kallmes, DF, Quilici, L, Cloft, HJ & Boccardi, E 2014, 'Treatment of cavernous sinus aneurysms with flow diversion: Results in 44 patients', American Journal of Neuroradiology, vol. 39, no. 5, pp. 948-951. https://doi.org/10.3174/ajnr.A3826
Puffer, R. C. ; Piano, M. ; Lanzino, Giuseppe ; Valvassori, L. ; Kallmes, David F ; Quilici, L. ; Cloft, H. J. ; Boccardi, E. / Treatment of cavernous sinus aneurysms with flow diversion : Results in 44 patients. In: American Journal of Neuroradiology. 2014 ; Vol. 39, No. 5. pp. 948-951.
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AU - Cloft, H. J.

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AB - 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.

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