Abstract Details

Title Flow Diversion for Fusiform/Dissecting vs. Saccular Vertebrobasilar Aneurysms: Results from the Posterior Circulation Flow Diversion Registry

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S10 - Vascular Interventions and Innovative Technologies (11:51 AM-12:03 PM)

Poster/Presentation
Number 004

Objective This study compared the effectiveness and safety of flow diverters (FD) for the treatment of fusiform/dissecting and saccular intracranial aneurysms (IAs) located in the vertebrobasilar vessels

Background The use of FD for vertebrobasilar IAs especially fusiform/dissecting ones has been described previously with inconsistent clinical and radiological results

Design/Methods This is an analysis of the posterior circulation FD registry, a multicentric observational registry that included data of patients with vertebrobasilar IAs. Patients and IAs characteristics and outcomes were compared between the fusiform/dissecting and saccular groups. Primary outcomes included complete occlusion (Raymond-Roy Class 1) at the latest follow-up and composite safety outcome (major stroke/procedure-related mortality for 1 year)

Results This study included 153 patients and IAs. Of those, 87 were fusiform/dissecting, while 66 were saccular. The fusiform/dissecting group were younger (median: 55 vs. 62 years, p=0.03) and occurred less in females (40.7% vs. 60.6%, p=0.023) as compared to the saccular group. The two groups were similar regarding presentation, Hunt and Hess, baseline modified Rankin Score (mRS), and previous-treatment. IAs location (mostly in vertebral artery: fusiform/dissecting, 58.6% vs. saccular, 42.4 %; p=0.95) was not different. The median size was higher in the fusiform/dissecting group as compared to the saccular group (9.9mm vs. 5.9mm, p<0.001). At an overall median follow-up time of 17.6 (IQR: 10.7-30.4 months), complete occlusion was observed in 62.6%, and was similar between the fusiform/dissecting and the saccular groups (61.4% vs. 64.2%, p=0.904). There was no difference in composite safety outcome (fusiform/dissecting, 9.2% vs. saccular, 10.8%, p=0.748) with an overall rate of 9.9%. The last follow up mRS 0-2 was similar between the two groups (p=0.582). Those who had mRS>2 tended to have worse outcomes and mRS at last follow up

Conclusions

FD is effective and safe for fusiform/dissecting as well as saccular IAs. Careful selection for FD treatment based on mRS is critical

Authors/Disclosures
Mahmoud Dibas, MD (Sulaiman Al Rajhi Colleges) PRESENTER	Mr. Dibas has nothing to disclose.
Juan A. Vivanco-Suarez, MD	Mr. Vivanco-Suarez has nothing to disclose.
Aaron E. Rodriguez-Calienes (University of Iowa Hospitals and Clinics)	Dr. Rodriguez-Calienes has nothing to disclose.
Gustavo Cortez	No disclosure on file
Vitor Pereira-Mendes	No disclosure on file
Hidehisa Nishi	No disclosure on file
Gabor Toth, MD (Cleveland Clinic Foundation)	Dr. Toth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dynamed. Dr. Toth has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Toth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kaneka. Dr. Toth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Penumbra.
Thomas Patterson (Cleveland Clinic)	No disclosure on file
David Altschul	No disclosure on file
Chaim Feigen	No disclosure on file
Muhammed Amir Essibayi (Albert Einstein College of Medicine)	No disclosure on file
Milagros Galecio-Castillo, MD (University of Iowa Hospitals and Clinics)	Dr. Galecio-Castillo has nothing to disclose.
Johanna T. Fifi, MD, FAAN (Mount Sinai Hospital)	Dr. Fifi has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Stryker, Inc. Dr. Fifi has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Microvention. Dr. Fifi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerenovus. Dr. Fifi has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Fifi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Serenity. Dr. Fifi has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MIVI. Dr. Fifi has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. Dr. Fifi has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. Dr. Fifi has stock in Endostream. Dr. Fifi has stock in Synchron. Dr. Fifi has stock in Imperative Care. Dr. Fifi has stock in Truvic. Dr. Fifi has stock in Bendit. Dr. Fifi has stock in Cerebrotech. Dr. Fifi has stock in Sim&Cure. Dr. Fifi has stock in Q'Apel. The institution of Dr. Fifi has received research support from Viz AI.
Stavros Matsoukas	No disclosure on file
Peter Kan	No disclosure on file
Muhammad Ubaid Hafeez, MD (University of Texas Medical Branch)	Dr. Hafeez has nothing to disclose.
Ajit Puri	No disclosure on file
Anna Luisa Kühn (UMass Memorial Medical Center)	No disclosure on file
Ajay Wakhloo	No disclosure on file
Margarita Rabinovich	No disclosure on file
Priyank Khandelwal, MD	Dr. Khandelwal has nothing to disclose.
Matias Costa	No disclosure on file
Stephen Monteith	No disclosure on file
Ricardo Hanel	No disclosure on file
Santiago Ortega Gutierrez, MD (University of Iowa)	Dr. Ortega Gutierrez has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for stryker. Dr. Ortega Gutierrez has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for medtronic. Dr. Ortega Gutierrez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. The institution of Dr. Ortega Gutierrez has received research support from stryker. The institution of Dr. Ortega Gutierrez has received research support from Medtronic. The institution of Dr. Ortega Gutierrez has received research support from Methinks. The institution of Dr. Ortega Gutierrez has received research support from NIH. The institution of Dr. Ortega Gutierrez has received research support from PCORI.

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