title: Endovascular Enterprise stent-assisted coil embolization for wide-necked unruptured intracranial aneurysms.
abstract: We evaluated the safety and efficacy of stent-assisted coil embolization for wide-necked unruptured intracranial aneurysms (UIA) based on the results observed in consecutive patients in a single center. This study included 116 patients (29 men, 87 women; mean age, 55.4 years) with 121 UIA which were treated by stent-assisted coil embolization from November 2008 to December 2010. A single stent type (Enterprise; Codman & Shurtleff, Raynham, MA, USA) was used. The clinical and radiological results were evaluated. Embolization was successful without complications in 94% of patients. Six patients had procedure-related thromboembolic events, resulting in neurologic symptoms in four patients, and transient angiographically-visible asymptomatic thromboembolism in two patients. Angiographic aneurysm occlusion was complete in 30.5% of patients, with a small neck remnant in 49.5%, and residual contrast filling in 19.8%. Dual antiplatelet agents were given for at least for 6 months. Thromboembolic stroke developed in three patients during follow-up; all occurred after discontinuation of clopidogrel and/or aspirin. Magnetic resonance angiography (MRA) follow-up was performed for at least 6 months. The mean follow-up was 13.4 months (range, 6-34 months). Eight patients (6.6%) demonstrated recanalization on MRA. Recoiling was performed in one patient (0.8%). The other seven patients with minor recanalization were conservatively followed. Enterprise stent-assisted coil embolization for the treatment of UIA appears to be effective and safe. Future studies including controlled prospective trials and careful follow-up are required to assess its indications and efficacy on a long term basis.
authors.affiliation: Department of Neurosurgery, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Sung-Kyun
authors.initials: SK
authors.lastname: Hwang
authors.forename: Gyojun
authors.initials: G
authors.lastname: Hwang
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Bang
authors.forename: Chang Wan
authors.initials: CW
authors.lastname: Oh
authors.forename: O-Ki
authors.initials: OK
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D055815:Young Adult
keywords: Efficacy; Enterprise stent; Safety; Stent-assisted coil embolization; Unruptured intracranial aneurysms