title: Delayed in-stent occlusion due to stent-related changes in vascular geometry after cerebral aneurysm treatment.
abstract: Stent-assisted coil embolization has been recently accepted as a treatment option for wide-neck or complex cerebral aneurysms. Delayed in-stent occlusion is described due to stent-related changes in vascular geometry. A 66-year-old man underwent stent-assisted coil embolization for an unruptured aneurysm of the vertebral artery. The treatment was successfully performed using the Enterprise stent. Follow-up angiography at 6 months showed asymptomatic in-stent occlusion. Three-dimensional analysis of the vascular geometry revealed that the left vertebral artery was straightened by 40° due to the stent placement. Such straightening of the vessel presumably caused kinking and occlusion of the vessel. Stent-related changes in vascular geometry may cause kinking of a vessel and result in occlusion after the treatment of cerebral aneurysms. Pre-treatment strategy may avoid this risk.
authors.affiliation: Department of Neurosurgery, Wakayama Rosai Hospital, Wakayama, Japan. vyr01450@gmail.com
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kono
authors.forename: Aki
authors.initials: A
authors.lastname: Shintani
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Terada
mesh_terms: D000368:Aged; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation*; D006083:Graft Occlusion, Vascular / Q000209:etiology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000628:therapy*; D008297:Male; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors; D014711:Vertebral Artery