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Issue: No. 101 (2026)
Section: Article
DOI: 10.58490/ctjump.2026i101.4616
Date Published: 20/08/2026
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Nguyen, X. T., Dang, H. Q., Pham, V. K., Nguyen, L. G., Ha, T. K., Bui, T. H., Bui, H. V., Nguyen, M. L., Pham, C. K. B., & Tran, C. C. (2026). EVALUATION OF ENDOVASCULAR INTERVENTION OUTCOMES IN THE TREATMENT OF WIDE-NECK INTRACRANIAL ANEURYSMS IN RELATION TO CYP2C19 GENOTYPE AND VASCULAR TORTUOSITY. Cantho Journal of Medicine and Pharmacy, 101, 168-173. https://doi.org/10.58490/ctjump.2026i101.4616

EVALUATION OF ENDOVASCULAR INTERVENTION OUTCOMES IN THE TREATMENT OF WIDE-NECK INTRACRANIAL ANEURYSMS IN RELATION TO CYP2C19 GENOTYPE AND VASCULAR TORTUOSITY

Xuan Toan Nguyen1, Hong Quan Dang1, , Vo Ky Pham2, Luu Giang Nguyen3, Thoai Ky Ha1, Tan Hung Bui2, Hoang Vu Bui2, Minh Ly Nguyen1, Cao Ky Bao Pham2, Chi Cuong Tran3
1 Can Tho University of Medicine and Pharmacy
2 Kien Giang General Hospital
3 Can Tho Stroke International Services

Main Article Content

Abstract

Background: Endovascular intervention using flow diverter stents is an advanced therapeutic approach for wide-neck intracranial aneurysms. Treatment efficacy and safety are significantly influenced by clopidogrel resistance (linked to CYP2C19 polymorphism) and vascular tortuosity. Objectives: To evaluate short-term outcomes of flow diverter stenting and investigate the relationship between technical outcomes, vascular tortuosity, and CYP2C19 polymorphism. Materials and methods:  A cross-sectional analytic study was conducted on 34 patients (36 aneurysms) undergoing endovascular treatment at Stroke International Services Can Tho Hospital from May 2025 to April 2026. Results: The mean age was 53.82 ± 13.49 years, with a female predominance (70.6%). The prevalence of patients carrying CYP2C19 polymorphisms was 47.1%. Anatomically, aneurysms were predominantly located in the internal carotid artery (91.2%). Complex vascular tortuosity (Type III/IV) accounted for 24.3%. Technical success reached 100%. The patients with Type IV tortuosity required balloon angioplasty assistance in 100% of cases (p=0.019). At the 90-day follow-up, 100% of patients were headache-free (p < 0.001) and achieved a modified Rankin Scale (mRS) score of 0. The overall complication rate was 8.8%, with no significant difference observed between genotype groups (p > 0.05). Conclusion: Endovascular treatment for intracranial aneurysms using flow diverter stents is safe and highly effective. Assessment of vascular tortuosity and CYP2C19 genotype is essential for predicting procedural difficulty and optimizing personalized antiplatelet therapy. 

Keywords

Endovascular intervention, CYP2C19, tortuosity, flow diverter stent

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