ABSTRACT

Objective

Flow-diverting stents are safely used for treating carotid artery aneurysms. Its use is limited in areas with dense branching, and more limited in posterior circulation arteries that have dense deep feeders. The aim of this study is to investigate the efficacy and safety of flow diverter stents in posterior circulation aneurysms.

Material and Methods

A total of 15 patients with subarachnoid hemorrhage and nine patients with incidental posterior circulation artery aneurysms, admitted to the clinic from 2019 to 2022, were included in the study. The procedure was performed on all patients under general anesthesia, with antiplatelet therapy being administered both before and after the procedure. Among these patients, 11 received a combination of flow-diverting stent and coiling, while 13 patients were treated solely with a flow-diverting stent. The Raymond-Roy classification and the modified Rankin Scale (mRS) score were employed to assess the occlusion rate and the outcome scores of the patients, respectively.

Results

In this group, 15 patients were discharged with an mRS score of 0, three patients with a score of 2, two patients with a score of 3, and one patient with a score of 4. Of the included patients, three patients died and three patients experienced thromboembolic events. Two patients developed dysphagia, which was resolved after six months. Two patients received second flow-diverting stent, as they had residual filling. Total occlusion was observed in 21 patients (6-18 months of follow-up).

Conclusion

Posterior circulation aneurysms are challenging to treat and carry elevated mortality and morbidity rates. Thanks to advancements in stent technology and the availability of new-generation antiplatelet medications, the risk of thromboembolism has been reduced. As a result, the utilization of flow-diverting stents in treating posterior circulation aneurysms has gained widespread acceptance for its safety and effectiveness.