To analyze the efficacy and safety of flow diverter (FD) only in treating vertebrobasilar aneurysms.

The clinical data of patients with vertebrobasilar aneurysms treated with FD in the First Affiliated Hospital of Harbin Medical University from January 2019 to May 2022 were analyzed retrospectively. Periprocedural complications were recorded and analyzed. The modified Rankin Scale (mRS) was used to evaluate the clinical outcomes, and the O'Kelly Marotta (OKM) grading scale was used to evaluate imaging outcomes.

A total of 38 patients harbouring 40 intracranial aneurysms treated with FD were enrolled. A total of 51 FDs were implanted, including 44 Pipeline embolization devices (PED) and 7 Tunbridge FDs, with a technical success rate of 100%. All FDs were successfully released with proper stent apposition. Thirty-eight patients underwent clinical follow-up, with a median follow-up time of 13.0 (2~47) months. The overall postprocedural complication rate was 13.2% (5/38). Among them, the periprocedural complication rate was 5.3% (2/28), and 3 (7.9%, 3/38) patients first experienced complications during the follow-up. The overall incidence of postprocedural ischemic complications was 13.2% (5/38), including 2 cases (2/38, 5.3%) of ischemia complicated with hemorrhagic complications. The rate of mRS >2 at the last follow-up was 10.52% (4/38), and the mortality rate was 7.9% (3/38). A total of 24 patients with 26 aneurysms underwent imaging follow-up, with a median follow-up time of 7 (5~18) months. Complete aneurysm occlusion (grade D of the OKM grading scale) was observed in 16 (61.5%) patients, and adequate aneurysm occlusion (grade C/D of the OKM grading scale ) was observed in 22 patients (84.60%). No aneurysm growth was observed.

FD was safe in treating vertebrobasilar aneurysms with a high procedure success rate. Imaging follow-up showed a high rate of adequate aneurysm occlusion with no growth. However, fatal ischemic complications remain to be noted.