Abstract Details

Title Flow Diversion for Distal Aneurysms of the Posterior Circulation: A Sub-analysis of the Post-FD Registry

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-008

Objective To investigate the outcomes of flow diversion for distal aneurysms of the posterior circulation.

Background Flow diversion (FD) has emerged as an effective treatment option for intracranial aneurysms (IAs). However, there is limited evidence regarding its safety and efficacy, specifically for distal aneurysms of the posterior circulation. This study aimed to investigate the outcomes of FD for aneurysms arising from the posterior inferior cerebellar artery (PICA), anterior inferior cerebellar artery (AICA), superior cerebellar artery (SCA), and the P2 and P3 segment of the posterior cerebral artery (PCA).

Design/Methods This sub-analysis of the posterior circulation FD (Post-FD) registry included data for patients harboring distal aneurysms of the posterior circulation in the PICA, AICA, SCA, and PCA P2-3 treated with FD. Aneurysm characteristics and outcomes were calculated for the total series, and a comparison was performed between fusiform/dissecting versus saccular aneurysms. Primary effectiveness was complete occlusion (Raymond Roy Class 1). Primary safety outcome was major stroke (ischemic/hemorrhagic). Secondary outcomes included retreatment and in-stent stenosis.

Results Overall, 36 patients with 36 aneurysms were treated with FD and had a median age, in years, of 60.0 (interquartile range [IQR]: 52.8-65.3 years). Of those, 13 were fusiform/dissecting while 23 were saccular IAs. Complete occlusion was achieved in 78.1% for all IAs at a median follow-up of 14.0 months (IQR: 9.3-48.6 months). There was a non-significant trend in rates of complete occlusion between fusiform/dissecting (91.7%) and saccular aneurysms (70%, p=0.151). Major stroke was reported in two cases (5.6%), in-stent stenosis in two (5.6%), and retreatment was required for four IAs (11.4%). There was no difference in rates of major stroke, in-stent stenosis, or retreatment between fusiform/dissecting and saccular IAs.

Conclusions This study suggests safety and efficacy of FD for distal aneurysms of the posterior circulation, particularly fusiform/dissecting aneurysms. Further larger-scale studies are warranted to confirm these findings.

Authors/Disclosures
Sophie L. Shogren, MD (University of Iowa Hospitals and Clinics) PRESENTER	Dr. Shogren has nothing to disclose.
Mahmoud Dibas, MD	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	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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