Endovascular treatment of complex intracranial aneurysms using intra/extra-aneurysmal stent

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• 作者：Feng Xu (1)
  Xuanfeng Qin (1)
  Yanlong Tian (1)
  Yuxiang Gu (1)
  Bing Leng (1)
  Donglei Song (1)
  
• 关键词：Neuroform stent ; Endovascular ; Complex ; Wide ; necked aneurysm ; Dissecting
• 刊名：Acta Neurochirurgica
• 出版年：2011
• 出版时间：April 2011
• 年：2011
• 卷：153
• 期：4
• 页码：923-930
• 全文大小：316KB
• 参考文献：1. Ahn JY, Han IB, Kim TG, Yoon PH, Lee YJ, Lee BH, Seo SH, Kim DI, Hong CK, Joo JY (2006) Endovascular treatment of intracranial vertebral artery dissections with stent placement or stent-assisted coiling. AJNR Am J Neuroradiol 27:1514-520
  2. Akpek S, Arat A, Morsi H, Klucznick RP, Strother CM, Maward ME (2005) Self-expandable stent-assisted coiling of wide-necked intracranial aneurysms: a single-center experience. AJNR Am J Neuroradiol 26:1223-231
  3. Alfke K, Straube T, Dorner L, Mehdorn HM, Jansen O (2004) Treatment of intracranial broad-neck aneurysms with a new self-expanding stent and coil embolization. AJNR Am J Neuroradiol 25:584-91
  4. Benitez RP, Silva MT, Klem J, Veznedaroglu E, Rosenwasser RH (2004) Endovascular occlusion of wide-necked aneurysms with a new intracranial microstent (Neuroform) and detachable coils. Neurosurgery 54:1359-367 CrossRef
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  6. Chow MM, Woo HH, Masaryk TJ, Rasmussen PA (2004) A novel endovascular treatment of a wide-necked basilar apex aneurysm by using a Y-configuration, double-stent technique. AJNR Am J Neuroradiol 25:509-12
  7. Chung J, Kim BS, Lee D, Kim TH, Shin YS (2010) Vertebral artery occlusion with vertebral artery-to-posterior inferior cerebellar artery stenting for preservation of the PICA in treating ruptured vertebral artery dissection. Acta Neurochir 152:1489-492 CrossRef
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• 作者单位：Feng Xu (1)
  Xuanfeng Qin (1)
  Yanlong Tian (1)
  Yuxiang Gu (1)
  Bing Leng (1)
  Donglei Song (1)
  
  1. Department of Neurosurgery, Huashan Hospital, Shanghai Medical School, Fudan University, 12# Wulumuqi Zhong Road, Shanghai, 200040, China
  

文摘

Background Intra/extra-aneurysmal stent placement for treatment of complex and wide-necked bifurcation aneurysms has been previously described. However, this technique has been rarely reported in the treatment of dissecting aneurysms with incorporated vessels. We assess the feasibility and effectiveness of intra/extra-aneurysmal stent-assisted coil embolization in the treatment of those complex intracranial aneurysms. Methods Between January 2009 and April 2010, nine consecutive patients with wide-necked or dissecting aneurysms with incorporated vessels underwent endovascular treatment using intra/extra-aneurysmal stent-assisted coiling at our institution. We assessed the clinical history, morphologic features of the aneurysms, treatment results, and follow-up. Results All Neuroform stents were successfully deployed in this series. Of the nine aneurysms treated with stent-assisted embolization, complete occlusion was achieved in seven aneurysms, nearly complete in one, and incomplete was present in one. There was no procedure-related complication in this series. Angiographic follow-up results of eight patients (mean, 8.6?months) showed continued obliteration of the aneurysms in six patients, incomplete occlusion in two patients, and the two patients received second treatment. On the modified Rankin Scale applied in follow-up, all patients were assessed as functionally improved or of stable clinical status. Conclusions Intra/extra-aneurysmal stent placement and subsequent coil embolization may be effective for the treatment of selected patients with complex intracranial aneurysms. Short-term follow-up data indicate good durability of stent-assisted aneurysm occlusion. However, further study with longer follow-up and larger case series is necessary for validation of the efficacy of this treatment modality.