Learning Curve for Flow Diversion of Posterior Circulation Aneurysms: A Long-Term International Multicenter Cohort Study

Adeeb N, Dibas M, Griessenauer CJ, Cuellar HH, Salem MM, Xiang S, Enriquez-Marulanda A, Hong T, Zhang H, Taussky P, Grandhi R, Waqas M, Aldine AS, Tutino VM, Aslan A, Siddiqui AH, Levy E, Ogilvy CS, Thomas AJ, Ulfert C, Mohlenbruch MA, Renieri L, Diestro JDB, Lanzino G, Brinjikji W, Spears J, Vranic JE, Regenhardt RW, Rabinov JD, Harker P, Mueller-Thies-Broussalis E, Killer-Oberpfalzer M, Islak C, Kocer N, Sonnberger M, Engelhorn T, Kapadia A, Yang VXD, Salehani A, Harrigan MR, Krings T, Matouk CC, Mirshahi S, Chen KS, Aziz-Sultan MA, Ghorbani M, Schirmer CM, Goren O, Dalal SS, Finkenzeller T, Holtmannspoetter M, Buhk JH, Foreman PM, Cress MC, Hirschl RA, Reith W, Simgen A, Janssen H, Marotta TR, Stapleton CJ, Patel AB, Dmytriw AA (2022)

Publication Type: Journal article

Publication year: 2022

Journal

DOI: 10.3174/ajnr.A7679

Abstract

BACKGROUND AND PURPOSE: Flow diversion has gradually become a standard treatment for intracranial aneurysms of the anterior circulation. Recently, the off-label use of the flow diverters to treat posterior circulation aneurysms has also increased despite initial concerns of rupture and the suboptimal results. This study aimed to explore the change in complication rates and treatment outcomes across time for posterior circulation aneurysms treated using flow diversion and to further evaluate the mechanisms and variables that could potentially explain the change and outcomes. MATERIALS AND METHODS: A retrospective review using a standardized data set at multiple international academic institutions was performed to identify patients with ruptured and unruptured posterior circulation aneurysms treated with flow diversion during a decade spanning January 2011 to January 2020. This period was then categorized into 4 intervals. RESULTS: A total of 378 procedures were performed during the study period. Across time, there was an increasing tendency to treat more vertebral artery and fewer large vertebrobasilar aneurysms (P = .05). Moreover, interventionalists have been increasingly using fewer overlapping flow diverters per aneurysm (P = .07). There was a trend toward a decrease in the rate of thromboembolic complications from 15.8% in 2011?13 to 8.9% in 2018?19 (P = .34).CONCLUSIONS: This multicenter experience revealed a trend toward treating fewer basilar aneurysms, smaller aneurysms, and increased usage of a single flow diverter, leading to a decrease in the rate of thromboembolic and hemorrhagic complications.

Authors with CRIS profile

Involved external institutions

Louisiana State University Health Sciences Center United States (USA) (US) Geisinger Health System United States (USA) (US) Harvard University United States (USA) (US) Capital University of Medical Sciences / 首都医科大学 China (CN) University of Utah United States (USA) (US) University at Buffalo. State University of New York United States (USA) (US) Rowan University United States (USA) (US) Iran University of Medical Sciences (IUMS) / دانشگاه علوم پزشکی ایران Iran, Islamic Republic of (IR) Paracelsus Medizinische Privatuniversität, Nürnberg Germany (DE) Orlando Health United States (USA) (US) Universitätsklinikum des Saarlandes (UKS) Germany (DE) Klinikum Ingolstadt Germany (DE) St. Michael's Hospital Canada (CA) Western University Canada (CA) Universitätsklinikum Heidelberg Germany (DE) Università degli Studi di Firenze / University of Florence Italy (IT) Mayo Clinic United States (USA) (US) Paracelsus Medizinische Privatuniversität Austria (AT) Istanbul University / İstanbul Üniversitesi Turkey (TR) Kepler Universitätsklinikum (KUK) Austria (AT) University of Toronto Canada (CA) University of Alabama at Birmingham (UAB) United States (USA) (US) University Health Network (UHN) Canada (CA) Yale University United States (USA) (US) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE)

How to cite

APA:

Adeeb, N., Dibas, M., Griessenauer, C.J., Cuellar, H.H., Salem, M.M., Xiang, S.,... Dmytriw, A.A. (2022). Learning Curve for Flow Diversion of Posterior Circulation Aneurysms: A Long-Term International Multicenter Cohort Study. American Journal of Neuroradiology. https://dx.doi.org/10.3174/ajnr.A7679

MLA:

Adeeb, N., et al. "Learning Curve for Flow Diversion of Posterior Circulation Aneurysms: A Long-Term International Multicenter Cohort Study." American Journal of Neuroradiology (2022).

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