title: The feasibility and efficacy of treatment with a Willis covered stent in recurrent intracranial aneurysms after coiling.
abstract: OBJECTIVE
  Aneurysm recurrence is an innate problem after coiling, and the recurrence rate is higher in complicated aneurysms. We evaluated the feasibility and efficacy of using the Willis covered stent in treating recurrent aneurysms after coil embolization.
  
  
  METHODS
  Eight aneurysms in 8 patients treated with detachable coils had confirmed recurrent aneurysms: 3 giant, 1 large, 1 dissecting, and 3 small wide-necked. The recurrent aneurysms involved C3 in 1 patient, C4 in 1, C7 in 5, and V4 in 1. A total of 11 covered stents were implanted into 8 target arteries. Follow-up angiography was performed 1-16 months after the procedure. Clinical follow-up data were collected and retrospectively analyzed, grading as fully recovered, improved, unchanged, or aggravated.
  
  
  RESULTS
  Willis covered stent placement succeeded technically in all of the aneurysms. No technique-related adverse event occurred. Total occlusion was achieved immediately in 6 aneurysms, and a small endoleak was observed in 2 aneurysms. No mortality or morbidity occurred during or after the procedures, including during the follow-up period. Follow-up angiograms revealed that all 8 of the recurrent aneurysms were completely isolated, and 8 parent vessels kept patency, except 1 with mild stenosis. Clinical neurologic symptoms fully resolved in 5 patients, improved in 1, and were unchanged in 2 at the end of the follow-up period.
  
  
  CONCLUSIONS
  In this small study with a middle-term follow-up, the Willis covered stent was used safely and effectively to occlude recurred aneurysms after coiling. Longer-term follow-up and additional clinical experience are needed to fully determine the safety and efficacy of the device.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: M-H
authors.initials: MH
authors.lastname: Li
authors.forename: Y-Q
authors.initials: YQ
authors.lastname: Zhu
authors.forename: C
authors.initials: C
authors.lastname: Fang
authors.forename: W
authors.initials: W
authors.lastname: Wang
authors.forename: P-L
authors.initials: PL
authors.lastname: Zhang
authors.forename: Y-S
authors.initials: YS
authors.lastname: Cheng
authors.forename: H-Q
authors.initials: HQ
authors.lastname: Tan
authors.forename: J-B
authors.initials: JB
authors.lastname: Wang
mesh_terms: D000328:Adult; D002533:Cerebral Angiography; D020099:Coated Materials, Biocompatible; D004621:Embolization, Therapeutic; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010865:Pilot Projects; D012008:Recurrence; D019233:Retreatment; D015607:Stents
chemical_list: D020099:Coated Materials, Biocompatible