ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1586956
This article is part of the Research TopicInnovation Application and Outcomes in Flow Diverter Interventions for Complex Intracranial AneurysmsView all articles
Flow Diverter Treatment for Proximal Middle Cerebral Artery Non-saccular Aneurysms: Multicenter Efficacy and Safety Analysis
Provisionally accepted
- 1Neurovascular Center, Department of Neurosurgery, Changhai Hospital, Naval Military Medical University, Shanghai, China
- 2Department of Neurosurgery, Jinjiang Municipal Hospital, Quanzhou, Fujian Province, China
- 3Neurovascular Center, Changhai Hospital, Shanghai, China
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OBJECTIVE: Proximal middle cerebral artery (MCA) non-saccular aneurysms present unique therapeutic challenges due to their morphology and proximity to critical branches. This study evaluates the safety, efficacy, and technical nuances of flow diverter (FD) devices in treating these lesions, with a focus on optimizing device selection and perioperative management.METHODS: A retrospective multicenter analysis included 43 patients with M1/M2 segment non-saccular aneurysms treated with FD between 2020–2024. Perioperative antiplatelet regimens were individualized based on platelet function assays and genotype analysis for CYP2C19 polymorphisms. Procedural outcomes, complications, and angiographic results were assessed. Virtual stent simulation was utilized in 62.8% of cases for preoperative planning.RESULTS: FD implantation achieved 100% technical success. Perioperative complications occurred in 4.7% (2 transient deficits, 1 hemorrhage). Follow-up angiography (median 8.4 months; n=38) demonstrated 92.1% complete occlusion (OKM-D), with 7.9% partial occlusion. In-stent stenosis occurred in 3 cases (7.9%), all asymptomatic. Clinical follow-up (median 25 months) revealed 97.7% favorable outcomes (mRS ≤2). Covered branches (M2, anterior temporal artery) exhibited stenosis in 23 cases and occlusion in 5, none clinically significant.CONCLUSION: FD therapy for proximal MCA non-saccular aneurysms achieves high occlusion rates with low morbidity, particularly when combined with preoperative simulation and genotype-guided antiplatelet regimens. This study suggests that FD devices may serve as a potential alternative for traditional surgical treatment for this kind of aneurysms.
Keywords: Intracranial Aneurysm, Middle Cerebral Artery, endovascular treatment, Flow diverter, Digital subtraction angiography
Received: 03 Mar 2025; Accepted: 17 Jun 2025.
Copyright: © 2025 Huang, Yao, Zou, Zhu, Wu and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qinghai Huang, Neurovascular Center, Department of Neurosurgery, Changhai Hospital, Naval Military Medical University, Shanghai, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.