title: Delayed thrombosis or stenosis following enterprise-assisted stent-coiling: is it safe? Midterm results of the interstate collaboration of enterprise stent coiling.
abstract: BACKGROUND
  Stent-assisted coiling of intracranial aneurysms with self-expanding stents has widened the applicability of neuroendovascular therapies to those aneurysms previously considered "uncoilable" because of poor morphology. The Enterprise Vascular Reconstruction Device and Delivery System (Cordis) has demonstrated promising initial short-term results. However, the rates of delayed in-stent stenosis or thrombosis are not known.
  
  
  OBJECTIVE
  To report midterm results of the Enterprise stent system.
  
  
  METHODS
  A 10-center registry was created to provide a large volume of data on the safety and efficacy of the Enterprise stent system. Pooled data were compiled for consecutive patients undergoing Enterprise stent-assisted coiling at each institution. Available follow-up data were evaluated for the incidence of in-stent stenosis, thrombosis, and aneurysm occlusion.
  
  
  RESULTS
  In total, 213 patients (176 females) with 219 aneurysms were treated with the Enterprise stent. One hundred ten patients had undergone delayed angiography (≥ 30 days from stent placement, mean follow-up 174.6 days). Forty percent of patients demonstrated total occlusion with 88% having ≥ 90% aneurysm occlusion. Six percent of patients had delayed (>30 days) angiographic findings, of which 3% demonstrated significant (≥ 50%) in-stent stenosis or occlusion. Seven delayed thrombotic events occurred (3%), along with 2 additional immediate periprocedural events. All 7 delayed events were concomitant to cessation of double-antiplatelet therapy.
  
  
  CONCLUSIONS
  Midterm occlusion rates are excellent, and stenosis and thrombosis rates are comparable to other available neurovascular stents. Interruption of antiplatelet therapy appears to be a factor in those developing delayed stenosis or thrombosis.
authors.affiliation: Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL, USA. jmocco@neurosurgery.ufl.edu
authors.forename: J
authors.initials: J
authors.lastname: Mocco
authors.forename: Kyle M
authors.initials: KM
authors.lastname: Fargen
authors.forename: Felipe C
authors.initials: FC
authors.lastname: Albuquerque
authors.forename: Bernard R
authors.initials: BR
authors.lastname: Bendok
authors.forename: Alan S
authors.initials: AS
authors.lastname: Boulos
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Carpenter
authors.forename: David J
authors.initials: DJ
authors.lastname: Fiorella
authors.forename: Brian L
authors.initials: BL
authors.lastname: Hoh
authors.forename: Jay U
authors.initials: JU
authors.lastname: Howington
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Liebman
authors.forename: Sabareesh K
authors.initials: SK
authors.lastname: Natarajan
authors.forename: Ansaar T
authors.initials: AT
authors.lastname: Rai
authors.forename: Rafael
authors.initials: R
authors.lastname: Rodriguez-Mercado
authors.forename: Adnan H
authors.initials: AH
authors.lastname: Siddiqui
authors.forename: Kenneth V
authors.initials: KV
authors.lastname: Snyder
authors.forename: Erol
authors.initials: E
authors.lastname: Veznedaroglu
authors.forename: L Nelson
authors.initials: LN
authors.lastname: Hopkins
authors.forename: Elad I
authors.initials: EI
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003251:Constriction, Pathologic; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D020767:Intracranial Thrombosis / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012042:Registries; D015607:Stents / Q000009:adverse effects*; D055815:Young Adult