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Stent-assisted coil embolization of intracranial wide-necked aneurysms

 Young-Jun Lee  ;  Dong Joon Kim  ;  Sang Hyun Suh  ;  Seung-Koo Lee  ;  Jinna Kim  ;  Dong Ik Kim 
 NEURORADIOLOGY, Vol.47(9) : 680-689, 2005 
Journal Title
Issue Date
Adult ; Aged ; Alloys ; Angiography, Digital Subtraction ; Catheterization ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/instrumentation* ; Embolization, Therapeutic/methods ; Feasibility Studies ; Female ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/pathology ; Intracranial Aneurysm/therapy* ; Male ; Middle Aged ; Stents* ; Treatment Outcome
Aneurysm ; intracranial Aneurysm ; therapy Arteries ; therapeutic embolization ; Stents and prosthesis
The endovascular treatment of cerebral aneurysms with coils poses significant technical challenges, particularly with respect to wide-necked aneurysms. We present the results of our initial experiences in using a stent for endovascular treatment of aneurysms, with an emphasis on potential applications, technical aspects, and associated complications. Twenty-three wide-necked aneurysms from 22 patients were treated during the 13-month study period. Seven patients presented with subarachnoid hemorrhage. Aneurysms were located at the internal carotid artery (n=14), the vertebral artery (n=3), the basilar artery (n=5), and the middle cerebral artery (n=1). A Neuroform stent2 was used for stent-assisted procedures. Premedication with antithrombotic agents was available for unruptured cases. Postprocedural antithrombotic medication was prescribed for all patients. Nineteen aneurysms were primarily stented, followed by coil placement. For five of these aneurysms, stenting was performed subsequent to failure of an attempt to frame with an initial coil. Stenting for the remaining four aneurysms was performed as a rescue procedure to prevent the migration of previously placed coils. Complete occlusion was obtained in ten aneurysms, nearly complete occlusion (95% or more occluded) in 11 aneurysms, and partial occlusion (less than 95% occluded) in one aneurysm. In one aneurysm, we failed to navigate the microcatheter into the aneurysmal sac through the interstices of the stent. Stent thrombosis was noted during the procedure in one patient. Hemorrhagic complication on the 25th day after the procedure was noted in one patient. No procedure-related complications were observed during the procedure or during follow-up in the remaining 20 patients, including seven patients who did not receive antithrombotic agents prior to endovascular treatment owing to recent subarachnoid hemorrhage. To overcome the technical limitation in the coiling of wide-necked aneurysms, stent-assisted coil embolization may be a technically feasible and relatively safe method, even though longer periods of follow-up are required.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Jinna(김진아) ORCID logo https://orcid.org/0000-0002-9978-4356
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
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