{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:30:53Z","timestamp":1788219053470,"version":"build-2803163510"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Aneurysmal persistence after flow diversion (FD) occurs in 5% to 25% of aneurysms, which may necessitate retreatment. There are limited data on safety\/efficacy of repeat FD\u2014a frequently utilized strategy in such cases.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A series of consecutive patients undergoing FD retreatment from 15 centers were reviewed (2011\u20132019), with inclusion criteria of repeat FD for the same aneurysm at least 6 months after initial treatment, with minimum of 6 months post-retreatment imaging. The primary outcome was aneurysmal occlusion, and secondary outcome was safety. A multivariable logistic regression model was constructed to identify predictors of incomplete occlusion (90%\u201399% and &lt;90% occlusion) versus complete occlusion (100%) after retreatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Ninety-five patients (median age, 57 years; 81% women) harboring 95 aneurysms underwent 198 treatment procedures. Majority of aneurysms were unruptured (87.4%), saccular (74.7%), and located in the internal carotid artery (79%; median size, 9 mm). Median elapsed time between the first and second treatment was 12.2 months. Last available follow-up was at median 12.8 months after retreatment, and median 30.6 months after the initial treatment, showing complete occlusion in 46.2% and near-complete occlusion (90%\u201399%) in 20.4% of aneurysms. There was no difference in ischemic complications following initial treatment and retreatment (4.2% versus 4.2%;\n              <jats:italic>P<\/jats:italic>\n              &gt;0.99). On multivariable regression, fusiform morphology had higher nonocclusion odds after retreatment (odds ratio [OR], 7.2 [95% CI, 1.97\u201320.8]). Family history of aneurysms was associated with lower odds of nonocclusion (OR, 0.18 [95% CI, 0.04\u20130.78]). Likewise, positive smoking history was associated with lower odds of nonocclusion (OR, 0.29 [95% CI, 0.1\u20130.86]). History of hypertension trended toward incomplete occlusion (OR, 3.10 [95% CI, 0.98\u20136.3]), similar to incorporated branch into aneurysms (OR, 2.78 [95% CI, 0.98\u20136.8]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Repeat FD for persistent aneurysms carries a reasonable success\/safety profile. Satisfactory occlusion (100% and 90%\u201399% occlusion) was encountered in two-thirds of patients, with similar complications between the initial and subsequent retreatments. Fusiform morphology was the strongest predictor of retreatment failure.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.120.033555","type":"journal-article","created":{"date-parts":[[2021,10,12]],"date-time":"2021-10-12T10:24:04Z","timestamp":1634034244000},"page":"1178-1189","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Repeat Flow Diversion for Cerebral Aneurysms Failing Prior Flow Diversion: Safety and Feasibility From Multicenter Experience"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2082-6892","authenticated-orcid":true,"given":"Mohamed M.","family":"Salem","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Teaching Hospital, Boston, MA (M.M.S., S.G.-P., G.A.M., J.M.M., C.S.O., A.J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2652-2451","authenticated-orcid":true,"given":"Ahmad","family":"Sweid","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University Hospitals, Philadelphia, PA (A.S., P.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9512-9461","authenticated-orcid":true,"given":"Anna L.","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Division of Interventional Neuroradiology, Department of Radiology, University of Massachusetts Medical Center, Worcester (A.L.K., A.S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0131-5699","authenticated-orcid":true,"given":"Adam A.","family":"Dmytriw","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Surgery, Toronto Western Hospital, University Health Network, ON, Canada (A.A.D., I.R., V.M.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2283-3612","authenticated-orcid":true,"given":"Santiago","family":"Gomez-Paz","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Teaching Hospital, Boston, MA (M.M.S., S.G.-P., G.A.M., J.M.M., C.S.O., A.J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2156-7391","authenticated-orcid":true,"given":"Georgios A.","family":"Maragkos","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Teaching Hospital, Boston, MA (M.M.S., S.G.-P., G.A.M., J.M.M., C.S.O., A.J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4500-7954","authenticated-orcid":true,"given":"Muhammad","family":"Waqas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, NY (M.W., E.I.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6444-2188","authenticated-orcid":true,"given":"Carmen","family":"Parra-Farinas","sequence":"additional","affiliation":[{"name":"Departments of Therapeutic Neuroradiology (C.P.-F., J.S., T.R.M.), St. Michael\u2019s Hospital, Toronto, ON, Canada."},{"name":"Surgery (C.P.-F., J.S., T.R.M.), St. Michael\u2019s Hospital, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0220-8676","authenticated-orcid":true,"given":"Arsalaan","family":"Salehani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama at Birmingham (A.S., M.R.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8668-7629","authenticated-orcid":true,"given":"Nimer","family":"Adeeb","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ochsner-Louisiana State University Hospital, Shreveport (N.A., H.H.C.-S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0041-2833","authenticated-orcid":true,"given":"Patrick","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Karolinska Universitetssjukhuset, Stockholm, Sweden (P.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5896-1782","authenticated-orcid":true,"given":"Gwynedd","family":"Pickett","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada (G.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0300-8572","authenticated-orcid":true,"given":"Jerry","family":"Ku","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology and Neurosurgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada (J.K., V.X.D.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"X.D. Yang","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology and Neurosurgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada (J.K., V.X.D.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0281-6201","authenticated-orcid":true,"given":"Alain","family":"Weill","sequence":"additional","affiliation":[{"name":"Department of Radiology, Service of Neuroradiology, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, QC, Canada (A.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Radovanovic","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Surgery, Toronto Western Hospital, University Health Network, ON, Canada (A.A.D., I.R., 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