title: Neuroform stent-assisted embolization of incidental anterior communicating artery aneurysms: long-term clinical and angiographic follow-up.
abstract: BACKGROUND
  Anterior communicating artery (A-comm) aneurysm is one of the most common intracranial aneurysms. Treatments include neurosurgical clipping or endovascular embolization.
  
  
  OBJECTIVE
  To retrospectively examine the long-term results of Neuroform stent-assisted coil embolization of incidental A-comms, with a focus on stent-associated stenosis, long-term angiographic aneurysm occlusion outcome, delayed stent-related thromboembolus, subsequent subarachnoid hemorrhage from the treated aneurysm, and procedural complications.
  
  
  METHODS
  Between January 7, 2003 and June 16, 2009, 44 Neuroform stents were placed as an adjunct to embolization of A-comms. Patient charts were reviewed retrospectively. Angiographic follow-up of at least 3 months (up to 6.5 years, mean 65 weeks) was available for 33 patients. Aneurysm occlusion success was determined using the Raymond classification for aneurysm remnants.
  
  
  RESULTS
  Referencing the last angiogram in the follow-up course, complete occlusion, dog-ear residual, residual neck, and residual aneurysm were found in 24, 2, 3, and 4 patients, respectively. Stenosis (45% and asymptomatic) of the artery where the stent had been placed was found in 1 patient. One patient had delayed transient ischemic attack after dual antiplatelet therapy was stopped prematurely. Retreatment based on the presence of residual aneurysm was performed or recommended in 2 patients. In 2 patients with residual or recurrent aneurysm filling, their age or clinical condition did not warrant retreatment.
  
  
  CONCLUSIONS
  Neuroform stent-assisted embolization provides long-term control of A-comms with a low incidence of aneurysm growth after treatment. The need for retreatment is uncommon, and retreatment is safe if performed. Subsequent bleeding from treated aneurysms was not observed in this study.
authors.affiliation: Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Raslan
authors.forename: Murat
authors.initials: M
authors.lastname: Oztaskin
authors.forename: Eric M
authors.initials: EM
authors.lastname: Thompson
authors.forename: Aclan
authors.initials: A
authors.lastname: Dogan
authors.forename: Bryan
authors.initials: B
authors.lastname: Petersen
authors.forename: Gary
authors.initials: G
authors.lastname: Nesbit
authors.forename: David S
authors.initials: DS
authors.lastname: Lee
authors.forename: Stanley L
authors.initials: SL
authors.lastname: Barnwell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome