Stent-assisted coil embolization of aneurysms with small parent vessels: safety and efficacy analysis. (3rd June 2015)

• Record Type: Journal Article
• Authors: Kühn, Anna Luisa; Hou, Samuel Y; Puri, Ajit S; Silva, Christine F; Gounis, Matthew J; Wakhloo, Ajay K
• Is Part Of: Journal of neurointerventional surgery. Volume 8:Number 6(2016)
• Page Start: 581
• Page End: 585
• Publication Date: 2015-06-03
• Subjects: Aneurysm -- Stent -- Coil; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2015-011774
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Background: Stent-assisted coil embolization (SACE) is a viable therapeutic approach for wide-neck intracranial aneurysms. However, it can be technically challenging in small cerebral vessels (≤2 mm). Objective: To present our experience with stents approved for SACE in aneurysms with small parent arteries. Methods: All patients who underwent stent-assisted aneurysm treatment with either a Neuroform or an Enterprise stent device at our institution between June 2006 and October 2012 were identified. Additionally, we evaluated each patient's vascular risk factors, aneurysm characteristics (ruptured vs non-ruptured, incidental finding, recanalized) and follow-up angiography data. Results: A total of 41 patients with 44 aneurysms met our criteria, including 31 women and 10 men. Most of the aneurysms were located in the anterior circulation (75%). Stent placement in vessels 1.2–2 mm in diameter was successful in 93.2%. Thromboembolic complications occurred in 6 cases and vessel straightening was seen in 1 case only. Initial nearly complete to complete aneurysm obliteration was achieved in 88.6%. Six-month follow-up angiography showed coil compaction in three cases, one asymptomatic in-stent stenosis and stent occlusion. Twelve to 20-months' follow-up showed stable coil compaction in two patients compared with previous follow-up, and aneurysm recanalization in two patients. Twenty-four to 36-months' follow-up showed further coil compaction in one of these patients and aneurysm recanalization in a previous case of stable coil compaction on mid-term follow-up. Conclusions: Our results suggest that SACE of aneurysms with small parent vessels is feasible in selected cases and shows good long-term patency rates of parent arteries.