Bilateral aneurysm

Sweid et al., from the Thomas Jefferson University Hospital analyzed the clinical and angiographic outcomes of 16 individuals with bilateral aneurysms who were treated with a two-stage flow diversion treatment at a tertiary referral center between January 2010 and July 2018.

One patient had two aneurysms treated with a single flow diverter (FD) on the contralateral side. The aneurysms treated were either ophthalmic artery aneurysm, superior hypophyseal artery aneurysm, posterior communicating artery aneurysm, or cavernous carotid aneurysms with an average size of 6.5 mm. There were no major complications such as in-stent stenosis, thromboembolic events, distal intra-parenchymal hemorrhage, re-rupture, stent migration, or neurological death. All patients had good functional outcomes. At 24 months follow-up, 81% of aneurysms showed complete occlusion of all treated aneurysms. No aneurysm required re-treatment.

This study demonstrates that a two-stage flow diversion treatment of bilateral aneurysms is both safe and efficacious. Timing of the contralateral flow diverter stent is critical. They found that 6 months allows for adequate neurological recovery and stent endothelialization ¹⁾.