Skip to main content
Log in

Endovascular treatment of intracranial aneurysms with the p64 flow diverter stent: mid-term results in 35 patients with 41 intracranial aneurysms

  • Interventional Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Introduction

The p64 flow diverter (FD) device is a fully resheathable and detachable stent dedicated for endovascular treatment (EVT) of intracranial aneurysms (IAs). We report our mid-term experience with this device.

Methods

Between January 2015 and February 2016, we retrospectively identified, in our prospectively maintained database, all patients treated with p64 FDs in two institutions. Independent clinical follow-up was performed by a vascular neurologist. Imaging follow-up included a digitalized subtraction angiography (DSA) at 3, 6, and 12 months and a magnetic resonance angiography (MRA) at 12 months.

Results

Thirty-nine patients (22 women/17 men; median age 54 years) with 48 IAs (median aneurysm size 6.2 mm; mean neck size 3.4 mm) were identified. All IAs were saccular and unruptured. Failure of safe stent delivery occurred in 15% of cases (7/48 IAs) which were excluded. Transient neurological morbidity occurred in 2/35 patients (5.7%) including one delayed thromboembolic complication. No permanent morbidity or mortality was encountered. Complete aneurysmal occlusion at 3, 6, and 12 months was 20/30 (66.6%), 18/27 (66.6%), and 24/28 (85.7%), respectively. Intra-stent stenosis was observed in 9/29 patients (31%) and classified as moderate in 4/29 (13.7%) and mild in 5/29 patients (17.2%). These stenoses gradually improved over time, with only mild stenoses being identified at 6 months and at 12 months.

Conclusion

In our small case series, the p64 FD stent appears safe and effective for EVT of IAs. A high occlusion rate and a low morbidity rate were observed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Lubicz B, Collignon L, Raphaeli G et al (2010) Flow-diverter stent for the endovascular treatment of intracranial aneurysms: a prospective study in 29 patients with 34 aneurysms. Stroke 41:2247–2253. doi:10.1161/STROKEAHA.110.589911

    Article  PubMed  Google Scholar 

  2. Lubicz B, Van der Elst O, Collignon L et al (2015) Silk flow-diverter stent for the treatment of intracranial aneurysms: a series of 58 patients with emphasis on long-term results. AJNR Am J Neuroradiol 36:542–546. doi:10.3174/ajnr.A4143

    Article  CAS  PubMed  Google Scholar 

  3. Alghamdi F, Morais R, Scillia P, Lubicz B (2015) The Silk flow-diverter stent for endovascular treatment of intracranial aneurysms. Expert Rev Med Devices 12:753–762. doi:10.1586/17434440.2015.1093413

  4. Lubicz B, Collignon L, Raphaeli G et al (2010) Pipeline flow-diverter stent for endovascular treatment of intracranial aneurysms: preliminary experience in 20 patients with 27 aneurysms. World Neurosurg 76:114–119. doi:10.1016/j.wneu.2011.02.015

    Article  Google Scholar 

  5. Walcott BP, Stapleton CJ, Choudhri O, Patel AB (2016) Flow diversion for the treatment of intracranial aneurysms. JAMA Neurol. doi:10.1001/jamaneurol.2016.0609

    Google Scholar 

  6. Colby GP, Lin L-M, Caplan JM et al (2016) Flow diversion of large internal carotid artery aneurysms with the surpass device: impressions and technical nuance from the initial North American experience. J Neurointerv Surg 8:279–286. doi:10.1136/neurintsurg-2015-011769

    Article  PubMed  Google Scholar 

  7. Briganti F, Leone G, Marseglia M et al (2015) Endovascular treatment of cerebral aneurysms using flow-diverter devices: a systematic review. Neuroradiol J 28:365–375. doi:10.1177/1971400915602803

    Article  PubMed  PubMed Central  Google Scholar 

  8. Briganti F, Leone G, Marseglia M et al (2016) p64 Flow Modulation Device in the treatment of intracranial aneurysms: initial experience and technical aspects. J Neurointerv Surg 8:173–180. doi:10.1136/neurintsurg-2015-011743

    Article  PubMed  Google Scholar 

  9. Fischer S, Aguilar-Pérez M, Henkes E et al (2015) Initial experience with p64: a novel mechanically detachable flow diverter for the treatment of intracranial saccular sidewall aneurysms. AJNR Am J Neuroradiol 36:2082–2089. doi:10.3174/ajnr.A4420

    Article  CAS  PubMed  Google Scholar 

  10. Kulcsár Z, Ernemann U, Wetzel SG et al (2010) High-profile flow diverter (Silk) implantation in the basilar artery: efficacy in the treatment of aneurysms and the role of the perforators. Stroke 41:1690–1696. doi:10.1161/STROKEAHA.110.580308

    Article  PubMed  Google Scholar 

  11. Wakhloo AK, Lylyk P, de Vries J et al (2015) Surpass flow diverter in the treatment of intracranial aneurysms: a prospective multicenter study. AJNR Am J Neuroradiol 36:98–107. doi:10.3174/ajnr.A4078

    Article  PubMed  Google Scholar 

  12. Becske T, Kallmes DF, Saatci I et al (2013) Pipeline for uncoilable or failed aneurysms: results from a multicenter clinical trial. Radiology 267:858–868. doi:10.1148/radiol.13120099

    Article  PubMed  Google Scholar 

  13. Alghamdi F, Mine B, Morais R et al (2016) Stent-assisted coiling of intracranial aneurysms located on small vessels: midterm results with the LVIS Junior stent in 40 patients with 43 aneurysms. Neuroradiology 58:665–671. doi:10.1007/s00234-016-1668-z

    Article  PubMed  Google Scholar 

  14. Rouchaud A, Leclerc O, Benayoun Y et al (2015) Visual outcomes with flow-diverter stents covering the ophthalmic artery for treatment of internal carotid artery aneurysms. AJNR Am J Neuroradiol 36:330–336. doi:10.3174/ajnr.A4129

    Article  CAS  PubMed  Google Scholar 

  15. de Carvalho FM, Caroff J, Pereira Dos Santos Neto E et al (2016) Flow changes in the posterior communicating artery related to flow-diverter stents in carotid siphon aneurysms. J Neurointerv Surg. doi:10.1136/neurintsurg-2016-012443

    Google Scholar 

  16. Neki H, Caroff J, Jittapiromsak P et al (2015) Patency of the anterior choroidal artery covered with a flow-diverter stent. J Neurosurg 123:1540–1545. doi:10.3171/2014.11.JNS141603

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ricardo Morais.

Ethics declarations

We declare that all human and animal studies have been approved by the Erasme University Ethics Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that due to the retrospective nature of this study, informed consent was waived.

Conflict of interest

Hôpital Erasme received a Phenox educational grant.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Morais, R., Mine, B., Bruyère, P.J. et al. Endovascular treatment of intracranial aneurysms with the p64 flow diverter stent: mid-term results in 35 patients with 41 intracranial aneurysms. Neuroradiology 59, 263–269 (2017). https://doi.org/10.1007/s00234-017-1786-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-017-1786-2

Keywords

Navigation