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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2023; 42(01): e19-e23
DOI: 10.1055/s-0041-1740021
Original Article

Endovascular Therapy of 103 Aneurysms in the Internal Carotid Artery with Flow Re-Direction Endoluminal Device

Terapia endovascular de 103 aneurismas na artéria carótida interna com dispositivo endoluminal de redirecionamento de fluxo
Vinicius Fialho Teixeira 
1   Neurology and Neurosurgery Department, Universidade Estadual do Pará (UEPA), Belém do Pará, PA, Brazil
,
Albedy Moreira Bastos 
1   Neurology and Neurosurgery Department, Universidade Estadual do Pará (UEPA), Belém do Pará, PA, Brazil
2   Neurology and Neurosurgery Department, Service of Neurosurgery of Universidade Estadual do Pará UEPA), Belém do Pará, PA, Brazil
,
Rafael Brito Santos 
1   Neurology and Neurosurgery Department, Universidade Estadual do Pará (UEPA), Belém do Pará, PA, Brazil
2   Neurology and Neurosurgery Department, Service of Neurosurgery of Universidade Estadual do Pará UEPA), Belém do Pará, PA, Brazil
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Abstract

Objective Intracranial aneurysms (AIs) are acquired vascular abnormalities that cause sacculations in the arterial wall and are present in ~2 to 5% of the population. Among the treatment options are endovascular interventions with the use of flow-redirecting stents. In the present study, we analyzed the flow re-direction endoluminal device (FRED).

Methods The present study aims to describe the results obtained from treatment with FRED in a series of patients affected by aneurysms in intracranial segments of the internal carotid artery. This is a cross-sectional, epidemiological, and observational study, whose data were obtained from the medical records of 81 patients from July 2018 to July 2019.

Results One hundred and three internal carotid artery aneurysms were observed in 81 patients, with a prevalence of women (91.35%), small (< 10 mm) (89.33%), and located at the C6 level (73.78%) of the internal carotid artery. Of the 81 patients, 16 had multiple aneurysms in the same artery. One hundred and three FRED stents were used in the treatment. These patients underwent angiography 6 months after the surgery, using the O'Kelly-Marotta classification (OKM) to assess the effectiveness of the device, and it was observed that: in 91 of the 103 procedures (88.34%), the FRED was fully open and well positioned, thus restoring the arterial flow and leading to a statistically significant result. In addition, a low complication rate (4.85%) was found, with ischemic stroke being the main complication (1.94%).

Conclusion This device can be an effective option in the treatment of internal carotid aneurysms since the aneurysm occlusion rate is excellent with a low rate of complications.

Resumo

Objetivo Aneurismas intracranianos (AIs) são anormalidades vasculares adquiridas, presentes em aproximadamente 2 a 5% da população, que causam saculações na parede arterial. Entre as opções de tratamento, estão as intervenções endovasculares com uso de stents de redirecionamento de fluxo. Neste estudo, analisamos o dispositivo de redirecionamento de fluxo endoluminal (FRED, na sigla em inglês).

Métodos Este estudo tem como objetivo descrever os resultados obtidos no tratamento com FRED em uma série de pacientes acometidos por aneurismas em segmentos intracranianos da artéria carótida interna. Trata-se de um estudo transversal, epidemiológico e observacional, cujos dados foram obtidos dos prontuários de 81 pacientes no período de julho de 2018 a julho de 2019.

Resultados Foram observados 103 aneurismas da artéria carótida interna em 81 pacientes, com a prevalência de mulheres (91,35%), aneurismas de pequeno porte (< 10 mm) (89,33%) e localizados no nível C6 (73,78%) da artéria carótida interna. Dos 81 pacientes, 16 apresentaram múltiplos aneurismas na mesma artéria. Cento e três stents FRED foram utilizados no tratamento. Esses pacientes foram submetidos à angiografia 6 meses após a cirurgia, e utilizando a classificação de O'Kelly-Marotta (OKM) para avaliar a eficácia do dispositivo, observou-se que em 91 dos 103 procedimentos (88,34%), o FRED estava totalmente aberto e bem-posicionado, levando assim à restauração do fluxo arterial e a um resultado estatisticamente significante. Além disso, foi encontrado baixo índice de complicações (4,85%), sendo o acidente vascular cerebral isquêmico a principal complicação (1,94%).

Conclusão Este dispositivo pode ser uma opção eficaz no tratamento dos aneurismas carotídeos internos, visto que a taxa de oclusão do aneurisma é excelente com baixa taxa de complicações

Keywords

stent - aneurysm - endovascular - treatment

Palavras-chave

stent - aneurisma - endovascular - tratamento


Publication History

Received: 08 February 2021

Accepted: 12 April 2021

Article published online:
07 December 2021

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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