Operative Neurosurgery 28:808–816, 2025
This retrospective case series describes six patients with acute iatrogenic intracranial pseudoaneurysms treated with flow diverter stents. The study demonstrates that, with appropriate antiplatelet regimens and repeat angiography, flow diverters are a safe and effective treatment for these complex vascular injuries.
• Flow diverter stents (FDs) were used to treat six cases of acute iatrogenic intracranial pseudoaneurysms at a single institution.
• Most injuries occurred during tumor resection or other neurosurgical procedures, affecting various intracranial arteries.
• All injuries resulted in pseudoaneurysm formation and were treated endovascularly, mainly with pipeline embolization devices (PEDs).
• No pseudoaneurysm recurrence, rebleeding, parent artery occlusion, or stenosis was observed in patients with available follow-up imaging.
• Complications were minimal; one transient ischemic attack and one case of epistaxis occurred, with no major adverse outcomes.
• Some pseudoaneurysms were not detected on initial angiography; repeated imaging within days was critical for diagnosis.
• Proper antiplatelet regimens (aspirin and ticagrelor or clopidogrel) were essential for safe FD use.
• The study supports FDs as a safe and effective option for managing complex acute iatrogenic intracranial pseudoaneurysms, highlighting the need for early repeat angiography when suspicion is high.
You must be logged in to post a comment.