{
  "abstract": "Introduction Several techniques for achieving wall apposition after flow diverter (FD) deployment are used in clinical practice. These include wire, micro-catheter or intermediate-catheter manipulation, balloon angioplasty, placement of a second FD or deployment of a laser-cut hybrid-design stent (HDS).Aim of study To provide data on safety and efficacy of HDS for managing FD wall apposition failure.Method Single center retrospective cohort of consecutive patients treated with a FD where wire and catheter manipulation techniques had failed to achieve sufficient wall apposition and deployment of an HDS was intended. All images were rated according to predefined criteria, which were in accordance with recently published international recommendations for grading of FD effectiveness and configurational changes.Abstract A230 Figure 1FD before (A,B) and after placement of OCS (C,D), showing improvement wall apposition after OCS placement with corresponding changes of the FD configuration (E)Results 50 patients with an intention to deploy an HDS within a FD were reviewed and deployment was successful in 49 (median age 58, 84% F). In 48 FD segments (proximal, middle, distal third) with wall apposition failure, covered by an HDS, full resolution of wall apposition failure was noted in 40 (83%) and some improvement in 6 (13%) patients. FD shortening after deployment of the HDS was frequent, but relatively minor in terms of magnitude. There was no delayed FD migration, and fishmouthing was never observed in segments covered by an HDS. Further details will be presented at the congress.Conclusion HDS deployment seems to be a safe and effective strategy for managing FD wall apposition in cases where low risk techniques have failed. This technique may additionally prevent long-term configurational changes of the FD rendering it useful for cases where the risk of the latter is expected to be high.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "Neuroradiology, University Hospital Tours, CHU Tours, Tours, France, Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland, Tours, France"
      ],
      "name": "Johannes Kaesmacher"
    },
    {
      "affiliations": [
        "Neuroradiology, Tours University Hospital, CHU Tours, Tours, France, Tours, France"
      ],
      "name": "Baptiste Donnard"
    },
    {
      "affiliations": [
        "Neuroradiology, Tours University Hospital, CHU Tours, Tours, France, Tours, France"
      ],
      "name": "Valere Barrot"
    },
    {
      "affiliations": [
        "Neuroradiology, Tours University Hospital, CHU Tours, Tours, France, Tours, France"
      ],
      "name": "Héloïse Ifergan"
    },
    {
      "affiliations": [
        "Neuroradiology, Tours University Hospital, CHU Tours, Tours, France, Tours, France"
      ],
      "name": "Fouzi Bala"
    },
    {
      "affiliations": [
        "Neuroradiology, Tours University Hospital, CHU Tours, Tours, France, Tours, France"
      ],
      "name": "Denis Herbreteau"
    },
    {
      "affiliations": [
        "Neuroradiology, Tours University Hospital, CHU Tours, Tours, France, Tours, France"
      ],
      "name": "Boulouis Grégoire"
    },
    {
      "affiliations": [
        "Neuroradiology, Tours University Hospital, CHU Tours, Tours, France, Tours, France"
      ],
      "name": "Richard Bibi"
    },
    {
      "affiliations": [
        "Neuroradiology, Tours University Hospital, CHU Tours, Tours, France, Tours, France"
      ],
      "name": "Kevin Janot"
    }
  ],
  "title": "A230 Flow diverter wall appositioning improvement using altas stenting – the wingman technique",
  "uid": "7d22bab6-9c63-5845-88e5-27a4866f26ec"
}