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Various Techniques of Stent-Assisted Coil Embolization of Wide-Necked or Fusiform Middle Cerebral Artery Aneurysms : Initial and Mid-Term Results

Authors
 Yu Sam Won  ;  Myung Ho Rho  ;  Byung Moon Kim  ;  Hee Jin Park  ;  Hyon Ju Kwag  ;  Eun Chul Chung 
Citation
 JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, Vol.53(5) : 274-280, 2013 
Journal Title
 JOURNAL OF KOREAN NEUROSURGICAL SOCIETY 
ISSN
 2005-3711 
Issue Date
2013
Keywords
Coil embolization ; Intracranial aneurysm ; Middle cerebral artery ; Stent
Abstract
OBJECTIVE: To evaluate the feasibility and clinical and angiographic outcomes of stent-assisted embolization for complex middle cerebral artery (MCA) aneurysms. METHODS: The records of 23 consecutive patients with 24 MCA aneurysms, who underwent stent-assisted embolization of the aneurysm, were retrospectively evaluated. RESULTS: Fifteen aneurysms were treated with one stent and 8 were treated using more than two stents (5 a stent-within-a-stent, 1 triple stents, and two Y-stent). Angiographically, complete or near complete occlusion was achieved in 15 aneurysms (65.2%), residual neck in five (21.7%), and residual aneurysm in three (13.1%). Five aneurysms demonstrated thrombosis within the stent during the procedure and hospitalization, and were resolved by intraarterial and intravenous Tirofiban injection. Symptomatic thromboembolic complications were developed in five patients and permanent deficits demonstrated in two patients with modified Rankin Scale 1 and 2, respectively. Treatment-related permanent morbidity and mortality rates were 8.3% and 0% with relatively high complication rate. Angiographic follow-up was available in 17 aneurysms at 6-31 months (mean, 13.2 months) and showed stable or improved in 15 (88.2%) and major and minor recurrence in one, respectively. CONCLUSION: Complex MCA aneurysms could be treated by stent-assisted coiling and showed lower recanalization rate during mid-term follow-up by effective flow diversion due to various stent-assisted techniques. Our results warrant further study with a longer follow-up period in a larger sample.
Files in This Item:
T201305921.pdf Download
DOI
10.3340/jkns.2013.53.5.274
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89296
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