Stent-assisted coiling of unruptured intracranial aneurysms: long-term follow-up in 164 patients with 183 aneurysms.
OBJECTIVE
Stent-assisted coiling (SAC) is increasingly used to treat complex unruptured intracranial aneurysms (UIA) including wide-necked and fusiform IA. However, few data are available over the long-term results of this technique. We report our 9-year-experience of SAC of UIA.


METHODS
A retrospective review of our prospectively maintained database identified all patients treated by SAC for an UIA in 2 institutions. The clinical charts, procedural data and angiographic results were reviewed.


RESULTS
Between 2004 and 2012, we identified 164 patients with 183 UIA. There were 115 women and 49 men with a mean age of 46 years. Embolization was successful in all patients. Procedural morbidity and mortality rates were 2.2% and 0% respectively. Immediate anatomical outcome included 54 complete occlusion (29.5%), 43 neck remnants (23.5%) and 86 incomplete occlusions (47%). Imaging follow-up was available in 137 patients (mean=26 months, range 3 to 99 months) and it showed 104 complete occlusions (75.9%), 23 neck remnants (16.8%) and 10 incomplete occlusions (7.3%). At follow-up, only 3 patients developed a significant intrastent stenosis, one of which was induced by radiosurgery. One of these patients had a symptomatic thrombo-embolic complication 3 years after stent placement.


CONCLUSIONS
SAC of complex UIA is effective and associated with low complication rates. Even if immediate anatomical results are relatively unsatisfying, mid- and long-term follow-up show a major improvement with a high rate of adequate occlusion that is stable over time. Moreover, the long-term clinical and angiographic tolerance of intracranial stents is excellent.
Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, 808, route de Lennik, 1070 Brussels, Belgium. Electronic address: benjamin_mine@me.com.
Benjamin
B
Mine
Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, 808, route de Lennik, 1070 Brussels, Belgium.
Ali
A
Aljishi
Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, 808, route de Lennik, 1070 Brussels, Belgium.
Jean-Bernard
JB
D'Harcour
Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, 808, route de Lennik, 1070 Brussels, Belgium.
Denis
D
Brisbois
Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, 808, route de Lennik, 1070 Brussels, Belgium.
Laurent
L
Collignon
Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, 808, route de Lennik, 1070 Brussels, Belgium.
Boris
B
Lubicz
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D001530:Belgium / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation* / Q000379:methods / Q000401:mortality*; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome
Endovascular procedure; Intracranial aneurysm; Stent-assisted coiling