Single centre experience of flow diverter treatment of complex intracranial aneurysms from South India: Intermediate and long-term outcomes.

Kannath, Santhosh K; Mohimen, Aneesh; Raman, Kapilamoorthy T; Abraham, Mathew; Nair, Suresh; Rajan, Jayadevan E

Background and Purpose To report the intermediate and long-term clinical and angiographic outcomes of the treatment of complex intracranial aneurysms with flow diverter (FD) stents. Setting A tertiary care centre from south India. Materials and Methods Patients treated with FD stents were retrospectively analyzed. The clinical demographics, technical success, angiographic, and long-term outcomes were recorded. Results A total of 13 patients underwent FD treatment, in whom 11 procedures were successful. The cohort included large or giant intracranial aneurysms and recurrent aneurysms following conventional endovascular treatment. Major morbidity was observed in 1 patient, who developed basal ganglia bleed that needed evacuation. Minor complications were seen in 36% of patients without clinical sequelae. Significant obliteration of aneurysm was noted on 1 month computed tomography angiogram in >80% of the patients. Angiographic complete obliteration was noted in 89% of the patients at 6 months. Cranial nerve deficits were noted in 2 patients that improved on subsequent follow up. There was no mortality observed in this cohort. Conclusion FD treatment of complex cerebral aneurysms was associated with favorable clinical and angiographic outcomes in the intermediate and long-term follow up. Minor complications were common, which needed to be effectively managed to prevent major catastrophic events. The steep learning curve influenced the technical success of the procedure.