Diffusion-weighted imaging–detected ischemic lesions associated with flow-diverting stents in intracranial aneurysms: safety, potential mechanisms, clinical outcome, and concerns

Christina Iosif (1) , Yann Camilleri (2) , Suzana Saleme (2) , François Caire (3) , Catherine Yardin (1) , Sanita Ponomarjova , Marie Paule Boncoeur-Martel (2, 4) , Charbel Mounayer (2)

1 ERMA - Equipe de Recherche Médicale Appliquée
2 Service de Neuroradiologie interventionnelle [CHU Limoges]
3 Service de Neurochirurgie [CHU Limoges]
4 NET - Neuroépidémiologie Tropicale

It was initially considered safe for flow-diverting stents to cover the ostia of branching vessels during endovascular procedures for the treatment of intracranial aneurysms. As more recent evidence suggests, however, their use is not always free of ischemic concerns in terms of covered arterial ostia. The authors sought to determine the frequency of silent and clinically evident diffusion-weighted imaging (DWI)-detected abnormalities related to stent placement as a means of elucidating potential clinical risks.

Mots clés: ACA = anterior cerebral artery; AChA = anterior choroidal artery; ACoA = anterior communicating artery; ARU = aspirin reaction unit; DSA = digital subtraction angiography; DWI = diffusion-weighted imaging; ECA = external carotid artery; MCA = middle cerebral artery; OKM = O'Kelly and Marotta; PCoA = posterior communicating artery; PRU = P2Y12 reactivity unit; SAH = subarachnoid hemorrhage; VA = vertebral artery; brain ischemia; cICA = cavernous segment of the internal carotid artery; diffusion-weighted imaging; intracranial aneurysms; mRS = modified Rankin Scale; stent; vascular disorders

Domaines: Santé publique et épidémiologie

Christina Iosif, Yann Camilleri, Suzana Saleme, François Caire, Catherine Yardin, et al.. Diffusion-weighted imaging–detected ischemic lesions associated with flow-diverting stents in intracranial aneurysms: safety, potential mechanisms, clinical outcome, and concerns. Journal of Neurosurgery, 2015, 122 (3), pp.627 - 636. ⟨10.3171/2014.10.JNS132566⟩. ⟨hal-01646668⟩