Complications of Flow Diverter Treatment for Intracranial Aneurysms: A Retrospective Single-Center Descriptive Study Publisher



Ghanaati H ; Rouzbahani M ; Mohaghegh P ; Soltani S ; Shakiba M ; Asadi J ; Ghanbarian D ; Rahmatian A ; Safi F
Source: Iranian Journal of Radiology Published:2025

Abstract

Background: Flow diverter (FD) devices have emerged as a promising option for treating intracranial aneurysms, particularly those that are complex or wide-necked. Although their efficacy in achieving aneurysm occlusion is well established, real-world data on complication rates remain limited. Objectives: The objective of this study was to describe the incidence and characteristics of complications following FD treatment of intracranial aneurysms in a single-center, real-world cohort. Patients and Methods: This retrospective, single-center study included 27 patients who underwent a total of 29 FD procedures for intracranial aneurysms. Demographic data, aneurysm morphology, and procedural details were collected. Due to the limited sample size and descriptive focus, no comparative statistical analyses were conducted. Continuous variables were summarized using means and standard deviations; categorical variables were presented as frequencies and percentages. Complication and mortality rates were reported with 95% confidence intervals (CIs) to reflect statistical uncertainty. Results: The mean patient age was 49.4 ± 12.8 years (range: 18 - 82), and 70.4% were female. Aneurysm types included saccular (79.3%), dissecting (13.8%), fusiform with wide neck (3.4%), and pseudoaneurysm (3.4%). Adjunctive coiling was used in 55.2% of procedures, with an average of 2.6 ± 2 coils per procedure. The overall complication rate was 13.8% (4/29; 95% CI: 3.9 - 31.7%) including stent migration, in-stent thrombosis, intracerebral hemorrhage, and complete carotid artery thrombosis. The mortality rate was 10.3% (3/29; 95% CI: 2.2 - 27.4%). One patient experienced permanent visual loss. Complete aneurysm occlusion was achieved in 82.8% of cases during follow-up. Due to the small number of patients treated with non-flow re-direction endoluminal device (FRED) devices, no subgroup comparisons were performed. Conclusion: These findings highlight the importance of close procedural monitoring and underscore the need for larger, prospective studies to further assess FD-related complications and long-term outcomes. Further studies with larger populations and longer follow-up periods are necessary to compare the efficacy and safety of different FDs. © 2025 Elsevier B.V., All rights reserved.