{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:13:11Z","timestamp":1790773991330,"version":"4.1.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The authors evaluate the rate and discuss the pathomechanisms of very late (\u2265 4-month) ischemic complications after flow-diverter stent (FDS) placement for intracranial aneurysms.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively reviewed the clinical data of the patients treated at Piti\u00e9-Salp\u00eatri\u00e8re Hospital between January 2010 and September 2014, who underwent FDS placement for intracranial aneurysm. The patients received dual-antiplatelet therapy (clopidogrel and aspirin) 5 days before and 3\u20136 months after the procedure and then aspirin alone for 6\u20139 months. An ischemic complication was defined as a sudden focal neurological deficit documented on diffusion-weighted images.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Eighty-six consecutive patients were included. Three (3.5%) patients treated with the Pipeline embolization device experienced a delayed acute ischemic stroke (2 cases of perforator\/side-wall branch infarction and 1 case of thromboembolic stroke) with an average delay of 384 days (4 months, 20 months, and 13 months, respectively). The aneurysm locations were the left superior cerebellar artery, the right anterior choroid artery, and the left internal carotid artery (paraclinoid segment), respectively. The complications occurred after the patients had completed the antiaggregation protocol, except for Patient 1, who was receiving aspirin alone because of a spontaneous hematoma. At the acute phase, no in-stent thromboses were found on digital subtraction angiography. In Patient 2, the treated anterior choroid artery was occluded 20 months after the procedure. In Patient 3, a focal stenosis (approximately 40%) of the distal aspect of the FDS, probably caused by intimal hyperplasia, was seen.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Very late ischemic complications after FDS treatment were observed in 3.5% of the cases in the authors' series, some of which occurred as late as more than 1 year after placement.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.10.jns15703","type":"journal-article","created":{"date-parts":[[2016,1,29]],"date-time":"2016-01-29T15:03:24Z","timestamp":1454079804000},"page":"929-935","source":"Crossref","is-referenced-by-count":59,"title":["Very late ischemic complications in flow-diverter stents: a retrospective analysis of a single-center series"],"prefix":"10.3171","volume":"125","author":[{"given":"Alexis","family":"Gu\u00e9don","sequence":"first","affiliation":[{"name":"Departments of Interventional Neuroradiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Claren\u00e7on","sequence":"additional","affiliation":[{"name":"Departments of Interventional Neuroradiology,"},{"name":"Paris VI University, Pierre et Marie Curie, Paris; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Di Maria","sequence":"additional","affiliation":[{"name":"Departments of Interventional Neuroradiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Rosso","sequence":"additional","affiliation":[{"name":"Paris VI University, Pierre et Marie Curie, Paris; and"},{"name":"Vascular Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Biondi","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology and Endovascular Therapy, Jean Minjoz University Hospital, Franche Comt\u00e9 University School of Medecine, Besan\u00e7on, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Gabrieli","sequence":"additional","affiliation":[{"name":"Departments of Interventional Neuroradiology,"},{"name":"Paris VI University, Pierre et Marie Curie, Paris; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Rojas","sequence":"additional","affiliation":[{"name":"Neuro-anesthesiology, Piti\u00e9-Salp\u00eatri\u00e8re Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Chiras","sequence":"additional","affiliation":[{"name":"Departments of Interventional Neuroradiology,"},{"name":"Paris VI University, Pierre et Marie Curie, Paris; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Sourour","sequence":"additional","affiliation":[{"name":"Departments of Interventional 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