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• W4286702023 abstract "<h3>Introduction</h3> Flow diversion is commonly used to treat intracranial aneurysms in various regions of the cerebral vasculature, but is only approved for use in the internal carotid arteries. Treatment of superior cerebellar artery (SCA) aneurysms with the Pipeline embolization device (PED) is sometimes performed, but has not been well-studied given the rare nature of these aneurysms. These aneurysms are also located in a perforator-rich region, which may influence their response to flow diversion, and makes them distinct from other intracranial aneurysms. Here, we report our experience with flow diversion of distal SCA aneurysms with PED. <h3>Methods</h3> Clinical and angiographic data of eligible patients was retrospectively obtained and assessed for key demographic characteristics and clinical and angiographic outcomes­­. Principal outcomes included rates of aneurysm occlusion, clinical complications, technical complication, and later development of in-stent stenosis. Aneurysm occlusion was quantified using the O’Kelly-Marotta scale. <h3>Results</h3> Two female and 1 male patient underwent flow diversion with PED for treatment of SCA aneurysms. Aneurysm sizes were 5.3 mm, 6.2 mm, and 10.7 mm. All aneurysms were saccular in morphology. Treatment indications were incidental, recent subarachnoid hemorrhage, and recurrence after prior coiling. One technical complication occurred, which was a retained microwire Clinical and angiographic follow-up was available for all patients. Complete aneurysm occlusion was achieved in 0% of cases, but all cases demonstrated angiographic improvement at final follow-up, with 2 instances of subtotal filling and 1 entry remnant observed. Following treatment, 1 patient experienced an ischemic stroke in the territory of the PED, while another experienced a transient ischemic attack in the territory of the PED. One patient had no ischemic complications after flow diversion, but did experience distal migration of the PED on angiographic follow-up. <h3>Conclusion</h3> While our data is preliminary and reflects the uncommon nature of these aneurysms, flow diversion of SCA aneurysms with PED appears to be carry a high risk of clinical complications and a low likelihood of complete aneurysm occlusion. Caution when pursuing flow diversion in these aneurysms is warranted. Further study in larger cohorts is necessary to better define clinical scenarios in which flow diversion or other interventions for SCA aneurysms should be considered. <h3>Disclosures</h3> <b>D. Lauzier:</b> None. <b>S. Cler:</b> None. <b>J. Osbun:</b> 2; C; Medtronic, Microvention. <b>A. Chatterjee:</b> None. <b>C. Moran:</b> 2; C; Medtronic, Cerenovus, Microvention, Stryker, Balt. <b>A. Kansagra:</b> 2; C; Microvention, Penumbra." @default.
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• W4286702023 date "2022-07-01" @default.
• W4286702023 modified "2023-09-25" @default.
• W4286702023 title "E-250 Flow diversion of superior cerebellar artery aneurysms" @default.
• W4286702023 doi "https://doi.org/10.1136/neurintsurg-2022-snis.361" @default.
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