Combined use of stents and coils to treat experimental wide-necked carotid aneurysms: preliminary results.
OBJECTIVE
To develop a new technique to treat wide-necked side-wall aneurysms, combining the implantation of intraarterial stents with the endosaccular placement of coils.


METHODS
Bilateral side-wall aneurysms were surgically created on the carotid arteries of four dogs. In each animal, Guglielmi detachable coils were introduced into one of the aneurysms after implantation of a balloon-expandable Strecker stent within the parent artery, adjacent to the aneurysm orifice. The contralateral aneurysms were treated with coils alone.


RESULTS
In two dogs, one of the stented and both nonstented aneurysms remained partially open for 4 weeks after subtotal packing with coils. In another two dogs, tight aneurysm packing with coils resulted in complete occlusion of all four aneurysms. Bulging of the coil mass resulted in 30% to 75% narrowing of the nonstented parent arteries. At 4 and 5 weeks, significant stenosis resulting from reactive hyperplasia was observed in all stented carotid arteries.


CONCLUSIONS
Based on these preliminary results, we conclude that Guglielmi detachable coils can be introduced into an aneurysm cavity through Strecker stents. The stents allow tighter packing of wide-necked aneurysms by preventing coils from migrating or bulging into the parent arteries.
Szikora
I
I
Dent Neurologic Institute, Buffalo, NY.
Guterman
L R
LR
Wells
K M
KM
Hopkins
L N
LN
D000783:Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D000818:Animals; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D004285:Dogs; D005500:Follow-Up Studies; D008722:Methods; D019736:Prostheses and Implants; D011859:Radiography; D015607:Stents