{
  "abstract": "Background Data about the safety and the efficacy of flow diversion for distal anterior cerebral artery (DACA) aneurysms are limited. We present the largest multicenter analysis evaluating the outcomes of flow diversion in unruptured DACA aneurysm treatment.Methods Databases from 39 centers were retrospectively reviewed for unruptured DACA aneurysms treated with flow-diverting stents. Demographics, clinical presentation, radiographic characteristics, procedural complications, and outcomes were assessed.Results A total of 168 patients with 168 unruptured DACA aneurysms were treated between January 2018 and December 2022. One hundred and twenty-five were women (74.4%) and the median age was 61 (IQR 52–67) years. The most common morphology was saccular (91.7%), with branch involvement in 61.9% of cases. Median parent vessel diameter was 1.9 mm (IQR 1.7–2.2) and stents were successfully deployed in 99.4% of cases. In 96.4% a single stent was implanted, while 3.6% of cases required two stents. Median imaging follow-up was 16.5 (IQR 7–24) months. At last follow-up the rate of occlusion (O’Kelly–Marotta scale C or D) was 82.1%. Symptomatic thromboembolic or hemorrhagic complications occurred in 5.3% of patients and the mortality rate was 0.6%. The rate of retreatment was 1.2%.Conclusions Flow-diverting stents are a reasonably safe and effective treatment option for unruptured DACA aneurysms.",
  "authors": [
    {
      "affiliations": [
        "Neuroradiology, Henri Mondor Hospital, Creteil, France"
      ],
      "name": "Luca Scarcia"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Pitié-Salpêtrière Hospital, Sorbonne University, APHP, 47, Bd de l'Hôpital, 75013, Paris, France",
        "Sorbonne University, Paris, France"
      ],
      "name": "Frédéric Clarençon"
    },
    {
      "affiliations": [
        "Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA",
        "Neurovascular Centre, Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Adam A Dmytriw"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Pitié-Salpêtrière Hospital, Sorbonne University, APHP, 47, Bd de l'Hôpital, 75013, Paris, France"
      ],
      "name": "Eimad Shotar"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Pitié-Salpêtrière Hospital, Sorbonne University, APHP, 47, Bd de l'Hôpital, 75013, Paris, France"
      ],
      "name": "Kevin Premat"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Pascal Jabbour"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Stavropoula I Tjoumakaris"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Reid Gooch"
    },
    {
      "affiliations": [
        "Diagnostic and Interventional Neuroradiology Department, Universitätsspital Basel, Basel, Switzerland"
      ],
      "name": "Marios-Nikos Psychogios"
    },
    {
      "affiliations": [
        "Diagnostic and Interventional Neuroradiology Department, Universitätsspital Basel, Basel, Switzerland"
      ],
      "name": "Nikolaos Ntoulias"
    },
    {
      "affiliations": [
        "Department of Radiology and Neuroradiology, Stadtspital, Zürich, Switzerland"
      ],
      "name": "Peter B Sporns"
    },
    {
      "affiliations": [
        "Division of Neurointerventional Radiology,Department of Radiology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA"
      ],
      "name": "Ajit S Puri"
    },
    {
      "affiliations": [
        "Division of Neurointerventional Radiology,Department of Radiology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA"
      ],
      "name": "Jasmeet Singh"
    },
    {
      "affiliations": [
        "Division of Neurointerventional Radiology,Department of Radiology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA"
      ],
      "name": "Anna Luisa Kuhn"
    },
    {
      "affiliations": [
        "Department of Neurology, Valley Baptist Medical Center, University of Texas Rio Grande Valley, Harlingen, Texas, USA"
      ],
      "name": "Ameer E Hassan"
    },
    {
      "affiliations": [
        "Department of Radiology, Ankara University, Ankara, Turkey"
      ],
      "name": "Oktay Algin"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany"
      ],
      "name": "Markus A Möhlenbruch"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany"
      ],
      "name": "Sophia Hohenstatt"
    },
    {
      "affiliations": [
        "Department of Neuroscience, Neuroradiological Unit, University of Turin, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy"
      ],
      "name": "Riccardo Russo"
    },
    {
      "affiliations": [
        "Department of Neuroscience, Neuroradiological Unit, University of Turin, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy"
      ],
      "name": "Mauro Bergui"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Geisinger Health System, Danville, Pennsylvania, USA"
      ],
      "name": "Oded Goren"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Geisinger Health System, Danville, Pennsylvania, USA"
      ],
      "name": "Matthew J Kole"
    },
    {
      "affiliations": [
        "Clinical Investigation Center (CIC), 1415, INSERM, Department of Interventional Neuroradiology, Teaching Hospital of Tours, Tours, France"
      ],
      "name": "Nourou Dine Adeniran Bankole"
    },
    {
      "affiliations": [
        "Clinical Investigation Center (CIC), 1415, INSERM, Department of Interventional Neuroradiology, Teaching Hospital of Tours, Tours, France"
      ],
      "name": "Richard Bibi"
    },
    {
      "affiliations": [
        "Clinical Investigation Center (CIC), 1415, INSERM, Department of Interventional Neuroradiology, Teaching Hospital of Tours, Tours, France"
      ],
      "name": "Gregoire Boulouis"
    },
    {
      "affiliations": [
        "Department of Data Science, Hyogo Medical University, Nishinomiya, Japan"
      ],
      "name": "Takeshi Morimoto"
    },
    {
      "affiliations": [
        "Department of Data Science, Hyogo Medical University, Nishinomiya, Japan"
      ],
      "name": "Fumihiro Sakakibara"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Strasbourg University Hospitals, Strasbourg, France"
      ],
      "name": "Raoul Pop"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Strasbourg University Hospitals, Strasbourg, France"
      ],
      "name": "Ciprian Juravle"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Kwong Wah Hospital, Hong Kong, Hong Kong"
      ],
      "name": "Joanna WK Ho"
    },
    {
      "affiliations": [
        "Servicio de Neurorradiología Intervencionista, Departamento de Neurocirugía, FLENI, Buenos Aires, Argentina"
      ],
      "name": "Angel Ferrario"
    },
    {
      "affiliations": [
        "Department of Neurology, Vascular Neurology Division, Institute of Neurological Research, FLENI, Buenos Aires, Argentina"
      ],
      "name": "Virginia Pujol Lereis"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USA"
      ],
      "name": "Jared Cooper"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USA"
      ],
      "name": "Chirag D Gandhi"
    },
    {
      "affiliations": [
        "UO Neuroradiologia, IRCCS Ospedale Policlinico San Martino, Genova, Italy"
      ],
      "name": "Giancarlo Salsano"
    },
    {
      "affiliations": [
        "UO Neuroradiologia, IRCCS Ospedale Policlinico San Martino, Genova, Italy"
      ],
      "name": "Lucio Castellan"
    },
    {
      "affiliations": [
        "Università Cattolica del Sacro Cuore, Rome, Italy"
      ],
      "name": "Arianna Camilli"
    },
    {
      "affiliations": [
        "Diagnostic and Interventional Neuroradiology Department, Hospital Foch, Suresnes, France",
        "University of Versailles, Saint Quentin-des-Yvelines, France, France"
      ],
      "name": "Arturo Consoli"
    },
    {
      "affiliations": [
        "Diagnostic and Interventional Neuroradiology Department, Hospital Foch, Suresnes, France"
      ],
      "name": "Alessandro Sgreccia"
    },
    {
      "affiliations": [
        "Department of Radiology and Neurosurgery, NYU Langone Health, New York, New York, USA"
      ],
      "name": "Eytan Raz"
    },
    {
      "affiliations": [
        "Department of Radiology and Neurosurgery, NYU Langone Health, New York, New York, USA"
      ],
      "name": "Charlotte Chung"
    },
    {
      "affiliations": [
        "Department of Radiology, Rouen University Hospital, Rouen, Normandy, France"
      ],
      "name": "Julien Burel"
    },
    {
      "affiliations": [
        "Department of Radiology, Rouen University Hospital, Rouen, Normandy, France"
      ],
      "name": "Chrysanthi Papagiannaki"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Lahore General Hospital, Lahore, Pakistan"
      ],
      "name": "Umair Rasheed"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Lahore General Hospital, Lahore, Pakistan"
      ],
      "name": "Khawaja Muhammad Baqir Hassan"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Tao Hong"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China"
      ],
      "name": "Zhe Ji"
    },
    {
      "affiliations": [
        "Department of Interventional Radiology, Turku University Hospital, Turku, Finland"
      ],
      "name": "Riitta Rautio"
    },
    {
      "affiliations": [
        "Department of Interventional Radiology, Turku University Hospital, Turku, Finland"
      ],
      "name": "Matias Sinislao"
    },
    {
      "affiliations": [
        "Neuroradiology Unit, AUSL della Romagna, Ravenna, Italy"
      ],
      "name": "Maria Ruggiero"
    },
    {
      "affiliations": [
        "Neuroradiology Unit, AUSL della Romagna, Ravenna, Italy"
      ],
      "name": "Elvis Lafe"
    },
    {
      "affiliations": [
        "Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy"
      ],
      "name": "Valerio Da Ros"
    },
    {
      "affiliations": [
        "Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy"
      ],
      "name": "Luigi Bellini"
    },
    {
      "affiliations": [
        "Neuroradiology Unit, Policlinico Universitario di Padova, Padua, Italy"
      ],
      "name": "Joseph D Gabrieli"
    },
    {
      "affiliations": [
        "Neuroradiology Unit, Policlinico Universitario di Padova, Padua, Italy"
      ],
      "name": "Giacomo Cester"
    },
    {
      "affiliations": [
        "Department Neurological Surgery, University of Washington, Seattle, Washington, USA"
      ],
      "name": "Michael R Levitt"
    },
    {
      "affiliations": [
        "Department Neurological Surgery, University of Washington, Seattle, Washington, USA"
      ],
      "name": "Kate T Carroll"
    },
    {
      "affiliations": [
        "Department Neurological Surgery, University of Washington, Seattle, Washington, USA"
      ],
      "name": "Zack A Abecassis"
    },
    {
      "affiliations": [
        "Neuroradiology Unit - Biomedical Sciences and of Morphologic and Functional Images, Universita degli Studi di Messina, Messina, Italy"
      ],
      "name": "Antonio Armando Caragliano"
    },
    {
      "affiliations": [
        "Neuroradiology Unit - Biomedical Sciences and of Morphologic and Functional Images, Universita degli Studi di Messina, Messina, Italy"
      ],
      "name": "Sergio L Vinci"
    },
    {
      "affiliations": [
        "Service de Neuroradiologie Interventionnelle et Diagnostique, Hôpital Purpan– CHU Toulouse, France"
      ],
      "name": "Guillaume Bellanger"
    },
    {
      "affiliations": [
        "Service de Neuroradiologie Interventionnelle et Diagnostique, Hôpital Purpan– CHU Toulouse, France"
      ],
      "name": "Christophe Cognard"
    },
    {
      "affiliations": [
        "Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France"
      ],
      "name": "Gaultier Marnat"
    },
    {
      "affiliations": [
        "Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France"
      ],
      "name": "Lisa Saleille"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Interventional Neuroradiology Unit, Careggi Universitary Hospital, Florence, Italy"
      ],
      "name": "Nicola Limbucci"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Interventional Neuroradiology Unit, Careggi Universitary Hospital, Florence, Italy"
      ],
      "name": "Francesco Capasso"
    },
    {
      "affiliations": [
        "Neuroradiology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy"
      ],
      "name": "Mariangela Piano"
    },
    {
      "affiliations": [
        "Neuroradiology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy"
      ],
      "name": "Claudia Rollo"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, AP-HP Nord, Hôpital Lariboisière, 75010, Paris, France"
      ],
      "name": "Alexis Guedon"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, AP-HP Nord, Hôpital Lariboisière, 75010, Paris, France"
      ],
      "name": "Francesco Arpaia"
    },
    {
      "affiliations": [
        "Neuroradiology Unit, IRCCS Policlinico San Matteo, 27100, Pavia, Italy"
      ],
      "name": "Andrea Romi"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, University Hospital Centre Besancon, Besancon, France"
      ],
      "name": "Fortunato Di Caterino"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, University Hospital Centre Besancon, Besancon, France"
      ],
      "name": "Alessandra Biondi"
    },
    {
      "affiliations": [
        "Neuroradiology, Henri Mondor Hospital, Creteil, France"
      ],
      "name": "Erwah Kalsoum"
    },
    {
      "affiliations": [
        "Research and Practical Centre for Endovascular Neuroradiology, the NAMS of Ukraine, Kyiv, Ukraine"
      ],
      "name": "Vyval Mykola"
    },
    {
      "affiliations": [
        "Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium"
      ],
      "name": "Adrien Guenego"
    },
    {
      "affiliations": [
        "Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA"
      ],
      "name": "Aman B Patel"
    },
    {
      "affiliations": [
        "Neurovascular Centre, Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Vitor M Pereira"
    },
    {
      "affiliations": [
        "Università Cattolica del Sacro Cuore, Rome, Italy",
        "UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Roma, Roma, Italy"
      ],
      "name": "Alessandro Pedicelli"
    },
    {
      "affiliations": [
        "UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Roma, Roma, Italy"
      ],
      "name": "Andrea Maria Alexandre"
    },
    {
      "affiliations": [],
      "name": "On behalf of the CRETA investigators"
    }
  ],
  "title": "Flow-diverting stents for the treatment of unruptured distal anterior cerebral artery aneurysms: analysis of the CRETA Registry",
  "uid": "ff8771a7-8ad0-5de2-a206-b1ad2c224f4e"
}