Endovascular treatment of large and giant intracranial aneurysms using flow-diverting stents.

Objective: The objective was to evaluate the efficacy of treatment of patients with large and giant cerebral arterial aneurysms using flow-diverting stents (FDSs).

Material And Methods: The treatment outcomes of 210 patients with large and giant intracranial aneurysms were analyzed. The study included patients with both asymptomatic and symptomatic aneurysms (manifested by SAH or pseudotumorous course). The rate of giant aneurysms was 62.3%.

Results: The technical success rate was 96%. In the perioperative period, the rate of clinically significant complications was 2.8%; the postoperative mortality was 3.3%. In the long-term period, total thrombosis of the aneurysm was observed in the majority of cases (80%) in the period from 4 to 12 months. Complete regression of clinical symptoms was observed in 26% of the cases, partial regression in 35%, and deterioration in 6% (of them, 4.9% of the cases were clinically significant). The long-term mortality was 2.5%.

Conclusion: FDS is a highly efficient device for remodeling of the arterial lumen at the level of large, giant and fusiform intracranial aneurysms that significantly reduces the number of deconstructive operations and decreases the risk of ischemic complications of endovascular treatment for this complex vascular pathology.