Lukas goertz <(>&<)> nina hesse <(>&<)> thomas liebig <(>&<)> wael ahmad <(>&<)> nuran abdullayev <(>&<)> boris krischek <(>&<)> christoph kabbasch <(>&<)> franziska dorn.Retreatment strategies for recurrent and residual aneurysms after treatment with flow-diverter devices.Interventional neuroradiology 62 (2020).Doi: 10.1007/s00234-020-02389-w the purpose of the study was to report clinical and angiographic outcomes of 11 patients that underwent retreatment for 12 aneurysms initially treated with flow-diverter stents.The median patient age was 53 years.Aneurysms (median size, 7.3 mm) were located at the internal carotid artery in 9 cases, and at the posterior circulation in 3 1.The patient was undergoing surgery to treat a ruptured, blister aneurysm located at the ica terminus with a max diameter of 1mm and a neck diameter of 1mm.A ped 4.5 x 22 was implanted without complications; however, the blister aneurysm grew.The patient was r etreated 16 days later with a ped 3.5 x 10 and ped 3.5 x 12 without complications.Angiographic follow up showed complete occlusion.2.The patient was undergoing surgery to treat an unruptured, saccular aneurysm located at the ica paraopthalmic with a max diameter of 25mm and a neck diameter of 8mm.A ped 4 x 12 and ped 4 x 10 were implanted without complications; however, there was no progressive aneurysm occlusion.The patient was retreated 417 days later with a ped 3.5 x 14 and ped 3.5 x 18.Complications included occluded side vessel, however, there was no deficit.Angiographic follow up showed entry remnant with significant stasis.3.The patient was undergoing surgery to treat an unruptured, saccular aneurysm located at the ica paraopthalmic with a max diameter of 10mm and a neck diameter of 5mm.A ped 4 x 14 and ped 4 x 16 were implanted without complications; however, there was no progressive aneurysm occlusion.The patient was retreated 118 days later with a ped 3.75 x 14 without complications.Angiographic follow up showed entryremnant with significant stasis.4.The patient was undergoing surgery to treat an unruptured, saccular aneurysm located at the ica paraopthalmic with a max diameter of 3.9mm and a neck diameter of 3.7mm.Retraction of a fdd due to misplacement resulted in vessel wall injury of the ica and consecutive carotid-cavernous fistula.The fistula could be occluded by implanting 3 peds.The patient did not have any symptoms after the intervention.However, there was no progressive aneurysm occlusion.The patient was retreated 427 days later with a ped 4 x 14 without complications.Angiographic follow up showed complete occlusion.5.The patient was undergoing surgery to treat a ruptured, dissecting aneurysm located at the va (v4) with a max diameter of 7.3mm and a neck diameter of 6.8mm.A ped 3.25 x 16 and ped 3.25 x 18 were implanted without complications; however, aneurysm recanalization occurred after initial complete occlusion.The patient was retreated 7 days later with a ped 3.75 x 20 without complications.Angiographic follow-up showed complete occlusion.6.The patient was undergoing surgery to treat 2 ruptured, saccular aneurysms.One located at the basilar tip with a max diameter of 4.7mm and a neck diameter of 6mm, and the other located at the suca with a max diameter of 2.2mm and a neck diameter of 2.2mm.A ped 2.5 x 10 was implanted without complications; however, fixation of in-stent thrombus occurred by an additional fdd implantation.The patient was retreated 22 days later with a ped 3.5 x 14.Complications included occluded side vessel; however, there was no deficit.Angiographic follow up showed complete occlusion.7.The patient was undergoing surgery to treat an unruptured, saccular aneurysm located at the ica paraopthalmic with a max diameter of 6.7mm and a neck diameter of 26mm.A ped was implanted without complications; however, aneurysm recanalization occurred after initial complete occlusion.The patient was retreated 105 days later with a ped 4.5 x 16 and ped 4.5 x 16 without complications.Angiographic follow up showed complete occlusion.
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