Surpass Streamline Flow Diverter for the Treatment of Craniocervical Unruptured Dissecting Aneurysms: A Multi-Institutional Retrospective Study.

Abstract

Currently, there is no established treatment consensus for craniocervical unruptured dissecting aneurysms (UDAs). This study aimed to assess the safety and efficacy of the Surpass Streamline Flow Diverter (SSFD) for treating craniocervical UDAs. A retrospective review of 3 centers' databases was conducted to identify patients with craniocervical UDAs treated with SSFDs from January 2021 to December 2023. Data, including patient and aneurysm characteristics, procedure details, imaging findings, and follow-up data were analyzed. The study included 35 patients with 35 craniocervical UDAs. The mean maximal length of the UDAs was 13.0 ± 6.0 mm, with 57% ranging from 10 to 25 mm. At a mean follow-up of 8.7 ± 2.5 months, the complete occlusion rate was 71% (25/35), with no recurrences detected. Perioperative complications occurred in 3 patients (9%), comprising ischemic stroke in 2 patients (6%) and hemorrhagic stroke in 1 patient (3%). All patients had a good clinical outcome at the 6-month follow-up (modified Rankin Scale <3). Multivariate logistic regression analysis revealed that aneurysmal dilation with stenosis (odds ratio = 0.034, 95% confidence interval: 0.001-0.845; P = 0.04) was a significant predictive factor for incomplete occlusion of treated aneurysms. Our findings suggest that SSFD is a safe and effective tool for craniocervical UDAs, demonstrating a high occlusion rate, acceptable complication rate, and good clinical outcome.