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PT  - JOURNAL ARTICLE
AU  - Puffer, R.C.
AU  - Piano, M.
AU  - Lanzino, G.
AU  - Valvassori, L.
AU  - Kallmes, D.F.
AU  - Quilici, L.
AU  - Cloft, H.J.
AU  - Boccardi, E.
TI  - Treatment of Cavernous Sinus Aneurysms with Flow Diversion: Results in 44 Patients
AID  - 10.3174/ajnr.A3826
DP  - 2014 May 01
TA  - American Journal of Neuroradiology
PG  - 948--951
VI  - 35
IP  - 5
4099  - http://www.ajnr.org/content/35/5/948.short
4100  - http://www.ajnr.org/content/35/5/948.full
SO  - Am. J. Neuroradiol.2014 May 01; 35
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: We identified 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 (&amp;lt;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. PEDPipeline Embolization Device