Flow diverter devices in the treatment of posterior communicating artery aneurysms: mid-term clinical and radiological outcomes

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Abstract Background In the last decade, flow diverter (FD) devices are one of the widely used endovascular methods in the treatment of intracranial aneurysms. As the frequency of its use is increasing progressively, we thought that studies concerned with the use of FD at specific locations are helpful to clarify the efficacy and safety of FD as a treatment option in cerebral aneurysms. We represent our experiences in the treatment of posterior communicating artery (PCOM) aneurysms by FD devices aiming to assess its angiographic efficacy (complete aneurysm occlusion) and its related complications. This is a retrospective study of 47 patients harboring 47 PCOM aneurysms treated with Pipeline Embolization Device (PED). Acutely ruptured and non-saccular aneurysms were excluded from the study. Short- and mid-term radiological and clinical outcomes were analyzed. Results Procedure-related complications were observed in five patients (two ischemic events, two transient ischemic attacks (TIA), and one ipsilateral distal hemorrhage) with no procedure-related mortality. Complete aneurysm occlusion was encountered in 87.2%. In multivariable analysis, large-sized aneurysm and incorporated vessels were an independent predictor of non-occlusion (P= 0.026 andP= 0.035 respectively). A favorable clinical outcome (modified Rankin Scale, 0–2) was observed in 45/47 patients (95.7%); the incidence of postoperative complications was an independent predictor of unfavorable clinical outcomes (P= 0.048). Conclusion PED stent provides a high occlusion rate in the treatment of PCOM aneurysms with good post-treatment clinical outcomes.

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