title: Treatment of complex intracranial aneurysms with a telescoping stent technique.
abstract: OBJECTIVE
  Complex intracranial aneurysms present a treatment challenge for both open and endovascular modalities of treatment. This report seeks to illustrate a series of patients with aneurysms treated with telescoping stents as a method of flow diversion for small and fusiform intracranial aneurysms.
  
  
  METHODS
  A retrospective evaluation of six patients treated with a telescoping stent technique utilizing available stents (at that time before the pipeline era) for complex cerebral aneurysms between January 2009 and January 2010 was performed. Five patients had dissecting aneurysms and one patient had a small superior hypophyseal artery aneurysm. One of the patients was treated in the setting of a Hunt and Hess grade IV subarachnoid hemorrhage. Follow-up cerebral angiography was performed postprocedure at 6 months.
  
  
  RESULTS
  At a mean follow-up period of 9 months, all the patients experienced complete or near-complete occlusion (>95%). No periprocedural complications were noted in this series. No episodes of hemorrhage or thromboembolic complications occurred.
  
  
  CONCLUSIONS
  Overlapping Neuroform and Enterprise stents may induce complete thrombosis of intracranial aneurysms and facilitate parent artery remodeling. The use of self-expanding stents is still an adequate treatment modality, especially if there is a need for vessel wall stabilization rather than flow diversion. The technique is also a sufficient alternative in small intracranial aneurysms not readily amenable to open surgical treatment or traditional endovascular coil embolization.
authors.affiliation: Department of Neurological Surgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
authors.forename: Nohra
authors.initials: N
authors.lastname: Chalouhi
authors.forename: Peter
authors.initials: P
authors.lastname: Campbell
authors.forename: Yamane
authors.initials: Y
authors.lastname: Makke
authors.forename: Sanjay
authors.initials: S
authors.lastname: Yadla
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Dumont
authors.forename: L Fernando
authors.initials: LF
authors.lastname: Gonzalez
authors.forename: Stavropoula
authors.initials: S
authors.lastname: Tjoumakaris
authors.forename: Barbara
authors.initials: B
authors.lastname: Albani
authors.forename: Robert H
authors.initials: RH
authors.lastname: Rosenwasser
authors.forename: Pascal
authors.initials: P
authors.lastname: Jabbour
mesh_terms: D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D002533:Cerebral Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology; D013923:Thromboembolism / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult