Early stage occlusion of non-ruptured intracranial aneurysms using flow diverter devices in Mexico

Mario Messina-López, Department of Neurosurgery, Hospital Puerta de Hierro Tepic, Tepic, Mexico
Charles Huamaní, Department of Interventional Neuroradiology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
Iván C. Baracaldo-Santamaría, Department Interventional Neuroradiology, Hospital Universitario Clínica San Rafael, Bogota, Colombia
Pablo Martínez-Arellano, Department of Internal Medicine, IMSS Hospital General de Zona con Unidad de Medicina Familiar N.° 8, Mexico City, Mexico
Alonso Gutiérrez-Romero, Department of Interventional Neuroradiology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
Yolanda Aburto-Murrieta, Department of Interventional Neuroradiology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
Jorge L. Balderrama-Bañares, Department of Neuroradiology, Hospital Español, Mexico City, Mexico
Héctor A. Montenegro-Rosales, Department of Neuroradiology, Hospital Médica Sur, Mexico City, Mexico
Diego López-Mena, Department of Interventional Neuroradiology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico

Objective: The objective of the study was to describe the rate of embolization success, the risk of complications, and the functional outcomes in the first 6 months post-treatment in patients with non-ruptured intracranial aneurysms (IAs) using flow-diverter (FD) devices in Mexico. Methods: Longitudinal, retrospective study of patients with non-ruptured IAs who were treated at the National Institute of Neurology and Neurosurgery between November 2020 and April 2022. After treatment with FD, post-procedure control angiograms were performed 6 months later. The occlusion rate was evaluated using the O’Kelly-Marotta scale. Results: There were 23 patients – 2 of whom had two IAs –, 20 women, with an average age of 51.4 years (± 13.3). A total of 19 saccular, 4 fusiform, and 2 dissecting IAs were treated. Measurements of the neck ranged from 1.9 to 19 mm. Angioplasties were performed as part of the procedure on four patients, and successful liberation was achieved after 23 procedures. Total occlusion was achieved in 14 IAs, and 3 had < 5% residual filling in the follow-up. Only three late procedural-related complications were found. Conclusions: The use of the FD devices in our population appears to be safe and to have a high level of effectiveness in early post-procedural months, supporting its use.

Keywords: Intracranial aneurysms. Blood vessel prosthesis. Interventional radiology.