title: Does a Low-wall Coverage Stent Have a Flow Diverting Effect in Small Aneurysms?
abstract: The flow diverting effect of a low-wall coverage stent remains controversial. We evaluted patients who underwent stenting for small aneurysms with a low but potential risk of growth and reviewed related literature.
  
  
  METHODS
  We evaluated 9 small aneurysms among 19 unruptured intracranial aneurysms from eight patients who underwent stenting. The patients had unexplainable severe headache (n = 8), aneurysm originating from the anterior choroidal artery (n = 3), potential growth or rupture risks including hypertension (n = 5), and multiple aneurysms (n = 6). Stents with a relatively low-wall coverage ratio (8-10%) were used. Clinical and angiographic outcomes were assessed.
  
  
  RESULTS
  One (n = 8) or two stents (n = 1) were used without any procedural difficulties or complications. Although no immediate changes of aneurysm morphology were observed, aneurysms decreased in size (n = 8) when examined by DSA (n = 8) or MRA (n = 1) during a median 28.9-month follow-up. There were no adverse events, including thromboembolism, aneurysm rupture, or stent movement during a median 31.9-month clinical follow-up (range: 17-69 months).
  
  
  CONCLUSIONS
  Although a variable degree of aneurysm size decrease may not prevent further growth or rupture of small aneurysms, stenting with a low-wall coverage ratio may have some advantageous hemodynamic effect. Flow modification of stent architecture vs. aneurysm characteristics, including size and location, on long-term outcome, requires further clarification.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. ; Department of Interventional Radiology, Taizhou People's Hospital, Taizhou, Jiangsu Province 225300, P. R. China.
authors.forename: Hairi
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jooae
authors.initials: J
authors.lastname: Choe
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Seung Chul
authors.initials: SC
authors.lastname: Jung
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Yunsun
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Ku Hyun
authors.initials: KH
authors.lastname: Yang
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Kye Jin
authors.initials: KJ
authors.lastname: Park
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Hae Won
authors.initials: HW
authors.lastname: Goo
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Won Hyong
authors.initials: WH
authors.lastname: Park
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Dae Chul
authors.initials: DC
authors.lastname: Suh
keywords: Hemodynamics; Intracranial aneurysm; Stent