Very short flow diverters for intracranial aneurysms: technical feasibility, angiographic outcomes, and clinical safety across diverse cerebrovascular locations
Neuroradiology, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00234-026-04235-x
- Dergi Adı: Neuroradiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Aerospace Database, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest), Technology Collection (ProQuest)
- Anahtar Kelimeler: Very short flow diverter stent, Intracranial aneurysm
- Uşak Üniversitesi Adresli: Evet
Özet
Background: Longer flow diverters (FDs) are often selected to facilitate deployment. Very short FDs (VSFDs; 10–12 mm) offer a targeted alternative, but technical complexity has limited their adoption, resulting in scarce clinical data. Methods: This single-center, retrospective cohort study included patients with intracranial aneurysms who underwent VSFD treatment. The primary outcome was technical success, defined as deployment of the intended VSFD across the aneurysm neck with complete neck coverage at the end of the index procedure, and analyzed per index aneurysm. Secondary outcomes included angiographic results, assessed using the O’Kelly–Marotta (OKM) grading scale, and clinical outcomes, evaluated with the modified Rankin Scale (mRS) during follow-up. Statistical analyses were performed using R software (version 4.5.2; R Foundation for Statistical Computing, Vienna, Austria). Results: Seventy-five patients harboring 151 aneurysms were included, with 86 index aneurysms treated using 93 VSFDs. Technical success was achieved in 82 of 86 index aneurysms (95.3%); the remaining 4 aneurysms required a second device because of malposition of the first. At a mean follow-up of 15.2 ± 11.0 months, complete occlusion was achieved in 42 of 49 patients with imaging follow-up (85.7%) and adequate occlusion in 49 of 49 (100%); imaging follow-up was unavailable in 26 of 75 patients (34.7%), so these proportions apply to the imaged subgroup only. Favorable clinical outcome (mRS 0–2) was obtained in 51 of 61 patients with clinical follow-up (83.6%), and no retreatment was required during follow-up. Postprocedural permanent neurological complications occurred in 5 of 75 patients (6.7%). Conclusions: VSFDs were technically feasible in selected intracranial aneurysms. Whether they offer any advantage over conventional-length devices was not tested in this study and requires anatomically matched comparison. Device malposition occurred only in the middle cerebral artery territory, and in every case the device had been deployed too proximally, so deployment from distal to proximal by experienced operators is essential.