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Self-expandable stent-assisted coiling of wide-necked intracranial aneurysms: a single-center experience Akpek S; Arat A; Morsi H; Klucznick RP; Strother CM; Mawad MEAJNR Am J Neuroradiol 2005[May]; 26 (5): 1223-31BACKGROUND AND PURPOSE: Endovascular treatment of wide-necked aneurysms remains a therapeutic challenge. We conducted this study to evaluate the angiographic results and clinical outcome of patients treated with stent-assisted coiling by using a recently available self-expandable intracranial stent. METHODS: A retrospective review of all patients treated with self-expandable stent-assisted coiling between September 2002 and December 2003 was done. Treatment was attempted in 32 patients with 35 aneurysms. Four of the aneurysms were ruptured. All had either a dome-to-neck ratio less than 2 and/or a neck diameter of 5 mm or larger. Following stent placement, coiling was attempted in 33 of 34 aneurysms. The technical success of the procedure, procedure related complications, and the angiographic results were documented. RESULTS: In 34 of 35 aneurysms, stent deployment across the neck of the aneurysm was successful. Coiling was performed successfully in 30 of 33 aneurysms. In 20 aneurysms, immediate posttreatment angiography showed either total (17%) or satisfactory (50%) occlusion. Procedure-related mortality occurred in one patient (3.1%). Adverse events occurred in eight patients (25%); in three of them permanent neurologic deficit resulted (9.3%). In six patients, thrombus formation occurred within the stented segments during the procedure and reopro infusion was used. Follow-up angiography was available in 12 (40%) of 30 treated aneurysms. CONCLUSION: In our practice use of the self-expandable stent seemed to facilitate endovascular treatment of wide-necked intracranial aneurysms. Difficulty of deployment and stent thrombogenicity are the main drawbacks of the system.|*Stents[MESH]|Adult[MESH]|Aged[MESH]|Catheterization[MESH]|Combined Modality Therapy[MESH]|Equipment Design[MESH]|Female[MESH]|Humans[MESH]|Intracranial Aneurysm/pathology/*therapy[MESH]|Male[MESH]|Middle Aged[MESH]|Retrospective Studies[MESH] |
