title: Circumferential and fusiform intracranial aneurysms: reconstructive endovascular treatment with self-expandable stents.
abstract: BACKGROUND
  We report our experience with endovascular treatment (EVT) of circumferential and fusiform intracranial aneurysms by a reconstructive approach with self-expandable stents.
  
  
  METHODS
  A retrospective review of our prospectively maintained database identified all circumferential and fusiform aneurysms treated by a reconstructive endovascular approach over a 3-year period. Clinical charts, procedural data, and angiographic results were reviewed.
  
  
  RESULTS
  From April 2004 to May 2007, 13 patients were identified, of whom 12 were asymptomatic and 1 presented with a subarachnoid hemorrhage. Two patients with an aneurysm <or=2 mm were treated by stent-within-stent placement without coiling (group 1). In 11 patients with a larger aneurysm, stenting with subsequent coiling was performed (group 2). In this latter approach, a balloon was temporarily inflated within the stent to ensure safe coil delivery. All patients showed an excellent clinical outcome. Asymptomatic procedural complications occurred in three patients, two with cervical internal carotid artery dissection and one with retroperitoneal hematoma. In patients of group 1, the aneurysm had completely disappeared at 6 months. In patients of group 2, aneurysm occlusion was complete in three and incomplete in eight. Follow-up angiography in 12 patients showed four with further thrombosis, six with stable results, and two with minor recanalization.
  
  
  CONCLUSIONS
  Circumferential and fusiform intracranial aneurysms may be treated by a reconstructive endovascular approach with self-expandable stents. In small aneurysms, a stent-within-stent technique is effective, whereas stenting and subsequent coiling is indicated in larger aneurysms. This therapeutic protocol is associated with good clinical and anatomical results.
authors: Department of Neuroradiology, Erasme University Hospital, Brussels, Belgium. blubicz@ulb.ac.be
authors: Boris
authors: B
authors: Lubicz
authors: Laurent
authors: L
authors: Collignon
authors: Florence
authors: F
authors: Lefranc
authors: Michaël
authors: M
authors: Bruneau
authors: Jacques
authors: J
authors: Brotchi
authors: Danielle
authors: D
authors: Balériaux
authors: Olivier
authors: O
authors: De Witte
mesh_terms: D000328:Adult; D017130:Angioplasty; D019917:Blood Vessel Prosthesis Implantation; D002533:Cerebral Angiography; D016208:Databases, Factual; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome