{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:40:57Z","timestamp":1785519657905,"version":"3.56.0"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The purpose of this study is to present the authors\u2019 medium-term results, with special emphasis on complications, occlusion rate of the aneurysm sac (digital subtraction angiography [DSA] and MRI), and the fate of cortical branches and perforating arteries covered (\u201cjailed\u201d) by the flow diverter (FD) stent.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Between January 2010 and September 2017, 29 patients (14 female) with 30 aneurysms were treated with an FD stent. Twenty-one aneurysms were at the middle cerebral artery bifurcation, 8 were in the anterior communicating artery region, and 1 was a pericallosal artery bifurcation. Thirty-five cortical branches were covered. A single FD stent was used in all patients. Symptomatic and asymptomatic periprocedural and delayed complications were reported. DSA and MRI controls were analyzed to evaluate modification of the aneurysm sac and jailed branches.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Permanent morbidity was 3.4% (1\/29), due to a jailed branch occlusion, with a modified Rankin Scale (mRS) score of 2 at the last follow-up. Mortality and permanent complication with poor prognosis (mRS score &gt; 2) rates were 0%. The mean follow-up time for DSA and MRI (mean \u00b1 SD) was 21 \u00b1 14.5 months (range 3\u201366 months) and 19 \u00b1 16 months (range 3\u201341 months), respectively. The mean time to aneurysm sac occlusion (available for 24 patients), including stable remodeling, was 11.8 \u00b1 6 months (median 13, range 3\u201327 months). The overall occlusion rate was 82.1% (23\/28), and it was 91.7% (22\/24) in the group of patients with at least 2 DSA control sequences. One recanalization occurred at 41 months posttreatment. At the time of publication, at the latest follow-up, 7 (20%) of 35 covered branches were occluded, 18 (51.4%) showed a decreased caliber, and the remaining 10 (28.5%) were unchanged. MRI T2-weighted sequences showed complete sac reabsorption in 7\/29 aneurysms (24.1%), and the remaining lesions were either smaller (55.2%) or unchanged (17.2%). MRI revealed asymptomatic and symptomatic ischemic events in perforator territories in 7\/28 (25%) and 4\/28 (14.3%) patients, respectively, which were reversible within 24 hours.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Flow diversion of bifurcation aneurysms is feasible, with low rates of permanent morbidity and mortality and high occlusion rates; however, recurrence may occur. Caliber reduction and asymptomatic occlusion of covered cortical branches as well as silent perforator stroke are common. Ischemic complications may occur with no identified predictable factors. MRI controls should be required in all patients to evaluate silent ischemic lesions and aneurysm sac reabsorption over time.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.7.jns18654","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:14:41Z","timestamp":1551226481000},"page":"1751-1762","source":"Crossref","is-referenced-by-count":62,"title":["Flow diversion treatment of complex bifurcation aneurysms beyond the circle of Willis: complications, aneurysm sac occlusion, reabsorption, recurrence, and jailed branch modification at follow-up"],"prefix":"10.3171","volume":"131","author":[{"given":"Caterina","family":"Michelozzi","sequence":"first","affiliation":[{"name":"Service de Neuroradiologie, H\u00f4pital Pierre-Paul Riquet, CHU de Toulouse; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Darcourt","sequence":"additional","affiliation":[{"name":"Service de Neuroradiologie, H\u00f4pital Pierre-Paul Riquet, CHU de Toulouse; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrien","family":"Guenego","sequence":"additional","affiliation":[{"name":"Service de Neuroradiologie, H\u00f4pital Pierre-Paul Riquet, CHU de Toulouse; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Christine","family":"Januel","sequence":"additional","affiliation":[{"name":"Service de Neuroradiologie, H\u00f4pital Pierre-Paul Riquet, CHU de Toulouse; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Tall","sequence":"additional","affiliation":[{"name":"Service de Neuroradiologie, H\u00f4pital Pierre-Paul Riquet, CHU de Toulouse; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Gawlitza","sequence":"additional","affiliation":[{"name":"Service de Neuroradiologie, CHU Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"Bonneville","sequence":"additional","affiliation":[{"name":"Service de Neuroradiologie, H\u00f4pital Pierre-Paul Riquet, CHU de Toulouse; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Cognard","sequence":"additional","affiliation":[{"name":"Service de Neuroradiologie, H\u00f4pital Pierre-Paul Riquet, CHU de Toulouse; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurointerv Surg","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1136\/neurintsurg-2014-011449","article-title":"Follow-up of intracranial aneurysms treated by flow diverter: comparison of three-dimensional time-of-flight MR angiography (3D-TOF-MRA) and contrast-enhanced MR angiography (CE-MRA) sequences with digital subtraction angiography as the gold standard","volume":"8","author":"Attali J","year":"2016","unstructured":"Attali J, Benaissa A, Soize S, Kadziolka K, Portefaix C, Pierot L: Follow-up of intracranial aneurysms treated by flow diverter: comparison of three-dimensional time-of-flight MR angiography (3D-TOF-MRA) and contrast-enhanced MR angiography (CE-MRA) sequences with digital subtraction angiography as the gold standard. 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