AUTHOR=Khanafer Ali , Henkes Hans , Cohen Jose , Albiña-Palmarola Pablo , Gomori John Moshe , Forsting Michael , von Gottberg Philipp 

TITLE=Endovascular treatment of distal anterior cerebral artery aneurysms using flow modulation devices: mid- and long-term results from a two-center study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1368612

DOI=10.3389/fneur.2024.1368612

ISSN=1664-2295

ABSTRACT=Flow-diverter (FD) stents have become an established treatment for intracranial aneurysms in recent years, but their use for aneurysms in distal cerebral vessels with small carrier vessel diameters remains controversial. This study describes the method and mid-and long-term outcomes of FD treatment of distal anterior cerebral artery aneurysms (DACAAs)at two neurointerventional centers, to elucidate this topic and provide more in-depth data. Methods Data for all patients at two neurointerventional centers who were treated with FDs for DACAAs in the pericallosal and supracallosal segment of the anterior cerebral artery were retrospectively analyzed. Data on periprocedural complications, and short-, mid-and long-term follow-up findings were recorded.Forty-one patients were eligible for inclusion in the study. Three FD models were used, one of which had an anti-thrombotic coating. Two periprocedural complications (5%) occurred but did not cause a change in the mRS. In the long-term follow-up, at 29 months and beyond, 83% of assessable patients showed complete occlusion of the aneurysms without new neurological deficits.FDs are a safe and effective treatment approach for DACAAs. This study indicated a low risk of complications, and high closure rates in short-, mid-and long-term follow-up.During the past 20 years, flow-diverters (FDs) have emerged as the most important technological innovation for endovascular treatment (EVT) of intracranial