Oversized self-expanding stents as an alternative to flow-diverters for blister-like aneurysms. (April 2014)

• Record Type: Journal Article
• Authors: Grant, Ryan A.; Quon, Jennifer L.; Bulsara, Ketan R.
• Is Part Of: Neurological research. Volume 36:Number 4(2014)
• Page Start: 351
• Page End: 355
• Publication Date: 2014-04
• Subjects: Neurology -- Periodicals; Neurosciences -- Periodicals; 616.8005
• DOI: 10.1179/1743132814Y.0000000321
• Languages: English
• ISSNs: 0161-6412

Abstract

<abstract> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec> <p> <bold>Objective:</bold> Blister-like aneurysms (BLAs) are challenging to treat. Their friable nature makes them high risk for both traditional microsurgical and endovascular treatments. We discuss employing a single oversized self-expanding stent in the treatment of these treacherous lesions.</p> <p> <bold>Methods:</bold> A retrospective review from our institution was conducted. Five patients with BLAs were identified, who went on to be treated with a single oversized self-expanding stent, defined as 1 mm larger than the parent vessel, by the senior author (KRB), who is dual fellowship trained in both cerebrovascular/skull base microsurgery and endovascular neurosurgery. Additionally, a literature review was performed on BLAs treated with sole stenting and outcomes discussed.</p> <p> <bold>Results:</bold> Our five patients had complete aneurysm occlusion at long-term follow-up and all had good neurological outcomes. The literature review demonstrated that most aneurysms at long-term follow-up were either completed occluded or progressively becoming occluded, with patients overall having a good functional outcome based on the modified Rankin scale (mRS).</p> <p> <bold>Conclusion:</bold> In our experience, oversized self-expanding stents are a treatment option that should be considered for BLAs. This strategy avoids the need for dual antiplatelet therapy and therefore increases its utility in the case of subarachnoid hemorrhage (SAH).</p> </sec> </abstract>