P-007 Flow Diversion versus Traditional Aneurysm Embolisation Strategies: Analysis of Fluoroscopy and Procedure Times

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Abstract

Background and Purpose

Flow diverters are increasingly used for treatment of complex intracranial aneurysms. The goal of this study was to compare the Pipeline Embolisation Device (PED) and traditional embolisation strategies in terms of fluoroscopy and procedure time.

Methods

Fluoroscopy and procedure times in minutes were retrospectively analysed and compared between 127 patients treated with PED, 86 patients treated with single-stage SAC, and 16 patients treated with Onyx HD 500 at our institution. A multivariate logistic regression analysis was performed to determine independent predictors of fluoroscopy and procedure time.

Results

The 3 groups were comparable with respect to patient age, gender, and ruptured/ unruptured aneurysm status. Aneurysms treated with PED were significantly larger than stent-coiled aneurysms and aneurysm location distribution differed significantly between the 3 groups. Mean fluoroscopy time was significantly increased in the SAC (55 ± 31 min, p>0.001) and Onyx HD 500 (91 ± 36 min, p>0.001) groups relative to PED (34 ± 23 min). Likewise, mean procedure time was significantly longer in SAC (155 ± 50 min, p>0.001) and Onyx HD 500 patients (176 ± 65 min, p>0.001) compared to PED (131 ± 36 min). Mean fluoroscopy and procedure times remained significantly longer in SAC and Onyx HD 500 patients compared with those who underwent placement of more than 1 PED. In multivariate analysis, SAC/Onyx HD 500 vs PED independently predicted both longer procedure and fluoroscopy times.

Conclusion

PED treatment requires significantly shorter fluoroscopy and procedure times compared with SAC and Onyx HD 500. The results of this study may be used by advocates of flow diverters as an additional argument for using this treatment modality to treat intracranial aneurysms.

Disclosures

N. Chalouhi: None. J. McMahon: None. L. Moukarzel: None. R. Starke: None. P. Jabbour: None. A. Dumont: None. S. Tjoumakaris: None. R. Rosenwasser: None. L. Gonzalez: None.

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