ArticleClinical neuroradiology2023
Acute Intraprocedural Thrombosis After Flow Diverter Stent Implantation: Risk Factors and Relevance of Standard Observation Time for Early Detection and Management.
Article in Clinical neuroradiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 14 citations in OpenAlex.
- Acute and Chronic Cerebral Hypoperfusion After Flow-Diverter Placement: Is There a Role for Extra-Intracranial Bypass? A Case Series and Narrative Literature Review.Neurology international · 2026Article
- In-Stent Stenosis After Surface-Modified Versus Uncoated Flow Diversion: a Randomized Trial (Derivo 2 Heal vs Derivo 2).Clinical neuroradiology · 2026Article
- Quantitative Assessment of Signal Intensity in PETRA-MRA Vs. TOF-MRA After Flow Diverter Stent Placement.Clinical neuroradiology · 2026Article
- Introducing the Caliber-Flow Status Scale (CFSS): a novel tool for assessing covered cortical branch status after flow diverter treatment of middle cerebral artery aneurysms.Journal of neurointerventional surgery · 2026Article
- Perioperative Antiplatelet Therapy in the New Flow Diversion Era.Journal of neuroendovascular therapy · 2026Review
- Short-term outcomes and hospitalization cost associated with flow diversion versus coil embolization for unruptured aneurysms: A national assessment.Clinical neurology and neurosurgery · 2026Article
- Conventional endovascular treatment and flow diverter for unruptured small- and medium-sized paraophthalmic segment aneurysms.Frontiers in neurology · 2025Article
- The SAFEST Study: Survey on Antiplatelets in Flow Diversion for Aneurysm Endovascular Treatment.Stroke (Hoboken, N.J.) · 2024Article
- Effectiveness of Flow Diverter Stents in the Treatment of Intracranial Aneurysms: Single-Center 10-Year Results.Cureus · 2024Article
- Prasugrel Single Antiplatelet Therapy versus Aspirin and Clopidogrel Dual Antiplatelet Therapy for Flow Diverter Treatment for Cerebral Aneurysms: A Retrospective Multicenter Study.AJNR. American journal of neuroradiology · 2024Article
- Long-term Follow-up After Aneurysm Treatment with the Flow Redirection Endoluminal Device (FRED) Flow Diverter.Clinical neuroradiology · 2024Article
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8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAcute intraprocedural thrombosis (AIT) is a severe complication of flow diverter stent (FDS) implantation for the treatment of intracranial aneurysms. Even though device-related thromboembolic complications are well known, there are no acknowledged risk factors nor defined surveillance protocols for their early detection. This study aimed to demonstrate that an angiographic active surveillance is effective to detect and treat AIT. Furthermore, we investigated risk factors for the occurrence of AIT.
methodsA prospective institutional protocol consisting of a defined observation period of 30 min following FDS deployment was established to detect AIT. Overall incidence, as well as the efficacy and safety of AIT treatment were assessed. Moreover, radiological and clinical outcomes of patients with AIT were analyzed. The influence of various patient- and procedure-related factors on the occurrence of AIT was investigated using multivariable forward logistic regression.
resultsDuring active surveillance twelve cases of AIT were observed among a total of 161 procedures (incidence: 7.5%). The median time of first observation was 15.5 min (IQR 9.5) after FDS implantation. The early recognition of AIT ensured a prompt treatment with intravenous application of a glycoprotein IIb/IIIa inhibitor, which led to complete thrombus resolution in all cases without hemorrhagic complications. Patients with pre-existing arterial hypertension and side branches originating from the aneurysmal sac had a higher risk of AIT (respectively OR, 9.844; OR, 3.553). There were two cases of re-thrombosis in the short-term postoperative period, of whom one died. The remaining patients with AIT had a good clinical outcome.
conclusionActive surveillance for 30 min after FDS implantation is an effective strategy for early detection and ensuing treatment of AIT and can thus prevent secondary sequalae. Hypertension and side branches originating from the aneurysmal sac may increase the risk of AIT.
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