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Intracranial Aneurysms in Children: The Role of Stenting and Flow‐Diversion
Author(s) -
Vargas Sergio A.,
Diaz Carlos,
Herrera Diego A.,
Dublin Arthur B.
Publication year - 2015
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12305
Subject(s) - medicine , flow diverter , radiology , surgery , aneurysm
OBJECTIVE To report a single‐center experience in the endovascular management of cerebral aneurysms in children with stenting and flow‐diversion techniques. METHODS During a 7‐year period, 5 male patients with six intracranial aneurysms (IA) were treated by endovascular therapy with stenting or flow‐diversion. The average age was 11 years (range 6‐18 years). RESULTS The etiology of the aneurysms was vasculopathic in 3 cases (50%), traumatic in 2 patients (33.3%), and idiopathic in 1 case (16.7%). Two‐thirds of the aneurysms were giant in size. The aneurysms were most frequently located in the anterior circulation (66.7%). Fifty percent of the aneurysms were treated with stenting and coiling, and 50% were treated with flow‐diversion stents alone. After treatment, occlusion was graded as: partial in five aneurysms (88.3%) and complete in 1 case (16.7%). Most cases (83.3%) had a good outcome after the procedure. During follow‐up, most aneurysms had progressive occlusion (80%), while the rest were unchanged (20%). Most stents and flow‐diverter devices remained patent (80%). However, one Pipeline flow‐diverter device in the Anterior cerebral artery (ACA) A2 segment had an asymptomatic occlusion. CONCLUSIONS In this series, device‐assisted endovascular techniques were a relatively safe and effective method of treatment of pediatric aneurysms. However, continued follow‐up is required after treatment, because there are unsolved issues regarding the durability of flow‐diverters and stents.