Frequency and predictors of endoleaks and long-term patency after covered stent placement for the treatment of intracranial aneurysms: a prospective, non-randomised multicentre experience.
OBJECTIVE
We investigated immediate/late endoleaks and long-term patency following stent-graft placement for treatment of intracranial aneurysms located within the distal internal carotid artery (ICA) or vertebral artery (VA).


METHODS
Forty-five aneurysms in 41 patients receiving covered stents in three centres were followed. Outcome measures included aneurysm occlusion rate, endoleaks, late in-stent stenosis rate, clinical improvement, neurological deficiencies and death.


RESULTS
Total aneurysm exclusion was achieved in 69.2% (n = 27), with 30.8% (n = 12) experiencing immediate residual endoleaks. Angiographic follow-up (mean 43.5 ± 14.3 months) revealed that 87.2% (n = 34) were completely occluded with only 12.8% (n = 5) showing residual endoleaks. Predictors of immediate endoleaks in our patient group were stent number (P = 0.023) and stent diameter (P = 0.022), while predictors of late endoleaks in our patient group were stent diameter (P = 0.035) and stent angulation (P = 0.021). Late in-stent stenosis rates were 18.0 ± 13.3 and 29.0 ± 18.5% compared with the period immediately following implantation at 2- and 6-year follow-ups respectively. Smoking (P = 0.017) and stent angulation (P = 0.020) were predictors of late in-stent stenosis.


CONCLUSIONS
Treating intracranial aneurysms with Willis stent-grafts has an acceptable immediate and late occlusion rate and long-term stented artery patency rate.
Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Medical School of Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai, 200233, China.
Yue-Qi
YQ
Zhu
Ming-Hua
MH
Li
Feng
F
Lin
Dong-Lei
DL
Song
Hua-Qiao
HQ
Tan
Bin-Xian
BX
Gu
Hong-Qi
HQ
Zhang
Bin
B
Leng
Pei-Lei
PL
Zhang
D000328:Adult; D002339:Carotid Arteries; D002533:Cerebral Angiography / Q000379:methods*; D057867:Endoleak / Q000000981:diagnostic imaging*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014654:Vascular Patency; D014711:Vertebral Artery