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Current Neurovascular Research


ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

Research Article

Is Flow Diversion the Death of Simple Coiling or Stent-assisted Coiling? A Single-center Experience

Author(s): Ryan J. Austerman, Saeed S. Sadrameli, Jaime R. Guerrero, Marcus Wong*, Orlando Diaz, Richard Klucznik, Yi J. Zhang and Gavin Britz

Volume 17 , Issue 5 , 2020

Page: [754 - 759] Pages: 6

DOI: 10.2174/1567202617999201125202131

Price: $65


Background: Since the introduction of endovascular methods to treat cerebral aneurysms, several technical advances have allowed a greater number of aneurysms to be treated endovascularly as opposed to open surgical clipping. These include flow diverting stents, which do not utilize coils and instead treat aneurysms by acting as an “internal bypass.” We sought to investigate whether flow diversion is replacing coiling at our institution.

Methods: A retrospective chart review on five years of data was conducted to investigate the possible increasing use of flow diversion devices compared to traditional simple or stent-assisted coiling.

Results: Over five years, the population revealed a trend toward an increased proportion of female patients, increased frequency of basilar tip and internal carotid artery (ICA) aneurysm location, increased hospital volume, and increased volume of patients treated by dual-trained neurosurgeons over interventional radiologists. Patients were stratified by aneurysm location and statistically significant differences were observed. Flow diversion devices were used with increasing frequency when treating aneurysms arising from the proximal internal carotid artery (Odds ratio (OR)=1.24, 95% CI: 1.02-1.50; p = 0.03), and middle cerebral artery (OR=2.60, 95% CI: 1.38-4.88; p = 0.003). Distal internal carotid artery aneurysm location came close to achieving statistical significance (OR=1.3, 95% CI: 0.99-1.72; p = 0.063).

Conclusion: In our single center experience at Houston Methodist Hospital, flow diversion devices are being used more frequently for aneurysms arising from the proximal ICA, MCA, and likely distal ICA (though this third location barely failed to achieve statistical significance.

Keywords: Flow diverter, endovascular, aneurysm, coiling, surgical clipping, flow diversion devices.

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