Treatment of intracranial aneurysms with the Enterprise stent: a multicenter registry.
OBJECTIVE
The development of self-expanding stents dedicated to intracranial use has significantly widened the applicability of endovascular therapy to many intracranial aneurysms that would otherwise have been untreatable by endovascular techniques. Recent Food and Drug Administration approval of the Enterprise Vascular Reconstruction Device and Delivery System (Cordis) has added a new option for self-expanding stent-assisted intracranial aneurysm coiling.


METHODS
The authors established a collaborative registry across multiple institutions to rapidly provide largevolume results regarding initial experience in using the Enterprise in real-world practice. Ten institutions (University at Buffalo, Thomas Jefferson University, University of Florida, Cleveland Clinic, Northwestern University, West Virginia University, University of Puerto Rico, Albany Medical Center Hospital, the Neurological Institute of Savannah, and the Barrow Neurological Institute) have provided consecutive data regarding their initial experience with the Enterprise.


RESULTS
In total, 141 patients (119 women) with 142 aneurysms underwent 143 attempted stent deployments. The use of Enterprise assistance with aneurysm coiling was associated with a 76% rate of > or = 90% occlusion. An inability to navigate or deploy the stent was experienced in 3% of cases, as well as a 2% occurrence of inaccurate deployment. Procedural data demonstrated a 6% temporary morbidity, 2.8% permanent morbidity, and 2% mortality (0.8% unruptured, 12% ruptured).


CONCLUSIONS
The authors report initial results of the largest series to date in using the Enterprise for intracranial aneurysm treatment. The Enterprise is associated with a high rate of successful navigation and low occurrence of inaccurate stent deployment. The overall morbidity and mortality rates were low; however, caution should be exercised when considering Enterprise deployment in patients with subarachnoid hemorrhage as the authors' experience demonstrated a high rate of associated hemorrhagic complications leading to death.
Mocco
J
J
Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
Snyder
Kenneth V
KV
Albuquerque
Felipe C
FC
Bendok
Bernard R
BR
Alan S
Boulos
B
Carpenter
Jeffrey S
JS
Fiorella
David J
DJ
Hoh
Brian L
BL
Howington
Jay U
JU
Jankowitz
Brian T
BT
Liebman
Kenneth M
KM
Rai
Ansaar T
AT
Rodriguez-Mercado
Rafael
R
Siddiqui
Adnan H
AH
Veznedaroglu
Erol
E
Hopkins
L Nelson
LN
Levy
Elad I
EI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002536:Cerebral Arteries / Q000473:pathology; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012042:Registries; D015607:Stents / Q000009:adverse effects; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult