Spontaneous delayed proximal migration of enterprise stent after staged treatment of wide-necked basilar aneurysm: technical case report.
OBJECTIVE
To document a unique technical issue with a relatively newly released intravascular stent used for adjunctive treatment of wide-necked cerebral aneurysms.


METHODS
A 48-year-old woman with a sister who had a large unruptured wide-necked basilar aneurysm underwent screening evaluation that revealed a nearly identical aneurysm. She also harbored small unruptured right superior cerebellar and left anterior cerebral artery aneurysms.


METHODS
Endovascular treatment of the 11.5-mm basilar aneurysm was performed in a staged manner. Stent placement was performed first, followed by delayed coil embolization of the aneurysm 9 weeks later. Follow-up angiography at the time of the second procedure revealed significant spontaneous proximal migration of the Enterprise Vascular Reconstruction Device and Delivery System (Cordis Neurovascular, Inc., Miami Lakes, FL) with the distal extent of the device migrating from the right P2 segment into the neck of the aneurysm. Coil embolization was performed despite migration of the vascular reconstruction device.


CONCLUSIONS
The use of stents in the endovascular treatment of cerebral aneurysms has vastly improved our ability to treat complex lesions. Technical issues remain with these devices, and description of this event may alter the way we use the Enterprise Vascular Reconstruction Device and Delivery System in terms of staging procedures, and when evaluating the particular vascular anatomy of the individual patient with special attention to parent artery vessel size.
Lavine
Sean D
SD
Department of Neurological Surgery, Columbia University Medical Center, New York, New York, USA. sl2081@columbia.edu
Meyers
Philip M
PM
Connolly
E Sander
ES
Solomon
Robert S
RS
D004621:Embolization, Therapeutic / Q000009:adverse effects*; D019544:Equipment Failure Analysis / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D009333:Neck; D015607:Stents / Q000009:adverse effects*