Endovascular treatment of intracranial aneurysms with parent vessel reconstruction using balloon and self expandable stents.
OBJECTIVE
To assess the feasibility and results of parent vessel stent reconstruction with balloon expandable and self-expandable stents in the treatment of intracranial aneurysms.


METHODS
In a total of 18 aneurysms balloon expandable (group A) and self expandable (group B) stents were used in 9 cases each. Stent implantation alone was used in 3 cases, and additional coil packing in the other 15.


RESULTS
Stents were successfully deployed in 8 out of 9 in group A and in 9 out of 9 cases in group B. Nearly complete occlusion was achieved in all but one case. At 3 or 6 months stable occlusion was found in 4 group A and 2 group B patients, progressive thrombosis in 3 cases in both groups, and recanalisation in 1 case in group B. Late follow up at 1-4 years demonstrated one progressive thrombosis one recanalisation and 1 stable occlusion in 3 group A, and 2 stable occlusions in 2 group B. patients. Complications included one aneurysm perforation in group A, one in-stent thrombosis and a distal arterial perforation in group B and one groin hematoma in both groups.


CONCLUSIONS
Stent reconstruction of intracranial arteries harbouring aneurysms is feasible and may result in aneurysm thrombosis without coil packing in some cases. Self expanding stents seem to provide a higher rate of success. Aggressive antiplatelet treatment increases the risk of hemorrhagic complications.
Szikora
I
I
National Institute of Neurosurgery, Budapest, Hungary. h13424szi@ella.hu
Berentei
Z
Z
Kulcsar
Z
Z
Barath
K
K
Berez
A
A
Bose
A
A
Nyary
I
I
D000328:Adult; D021721:Balloon Occlusion / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D020767:Intracranial Thrombosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D015607:Stents / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods