Treatment of wide-necked intracranial aneurysms with a self-expanding stent: mid-term results.
OBJECTIVE
To evaluate mid-term clinical and angiographic results after using a self-expanding neurovascular stent and coils for the management of broad-based intracranial aneurysms.


METHODS
During the period from August 2001 to October 2004 we treated a total of 42 patients with 44 aneurysms using a self-expandable stent. To date we have data on more than 6 months of follow-up in 25 patients with 26 aneurysms. Aneurysm occlusion was divided into the following categories: 100 % (complete), 95-99 % (subtotal), and < 95 % (incomplete).


RESULTS
In 15 aneurysms complete occlusion, in 11 aneurysms subtotal occlusion was initially achieved. Control DSA showed progressive thrombosis in seven aneurysms leading to total occlusion in another 4 aneurysms. Three recanalizations were observed in one large and two giant ICA aneurysms. No vessel occlusion occurred. One vessel stenosis of the stented segment was noted, but it was not clinically relevant. One patient experienced a small embolic infarction after stopping antiplatelet medication. No persistent deterioration of the clinical status occurred.


CONCLUSIONS
Combining a stent with coils seems to be an acceptable treatment option for broad-based intracranial aneurysms. As this special subgroup of treated aneurysms includes only those with an unfavourable geometry, the results are extremely promising.
Wanke
I
I
Department of Neuroradiology, University Hospital of Essen, Germany. isabel.wanke@uni-essen.de
Doerfler
A
A
Goericke
S
S
Gizewski
E R
ER
Sandalcioglu
E
E
Moemken
S
S
Stolke
D
D
Forsting
M
M
D017542:Aneurysm, Ruptured / Q000601:surgery; D000077144:Clopidogrel; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery; D013927:Thrombosis / Q000517:prevention & control; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine