title: Stent-assisted coiling of very small wide-necked intracranial aneurysms: Complications, anatomical results and clinical outcomes.
abstract: OBJECTIVE
  Treatment of very small (≤3mm) wide-necked intracranial aneurysms remains controversial, we investigated the efficacy and safety of stent-assisted coiling of such aneurysms.
  
  
  METHODS
  From September 2008 to December 2012, 112 very small wide-necked intracranial aneurysms in 108 patients were embolized with stent-assisted coiling. We assessed the initial neurological conditions, complications and anatomic results. The follow-up results were evaluated with DSA and mRS.
  
  
  RESULTS
  Stent deployment was successful in 104 of 108 procedures (96.3%). 11 complications (10.2%) occurred during procedures, including 5 events of aneurysm rupture, 3 events of thromboembolism. The rate of complication, rupture and thromboembolism was not statistically different between the ruptured and unruptured patients (P=0.452, P=0.369, P=1.000, respectively). The initial aneurysmal occlusion was Raymond scale (RS) 1 in 34 patients (31.5%), RS2 in 53 patients (49.1%), and RS3 in 21 patients (19.4%). 79 aneurysms were available for anatomic follow-up of 12-47 months, stable occlusion in 45 aneurysms (57.0%), progressive complete occlusion in 34 aneurysms (43.0%). 95 patients(88.0%) were available for a clinical follow-up of 12-52 months, 92 patients (96.8%) had favorable clinical outcomes (mRS ≤2), 3 patients (3.2%) had morbidity (mRS: 3-5). The morbidity was not statistically different between the ruptured and unruptured patients (P=1.000).
  
  
  CONCLUSIONS
  Stent-assisted coiling of very small wide-necked intracranial aneurysms may be effective and safe. Because of low risk of rupture in such aneurysms, the coiling of unruptured such aneurysms must be selective. The long-term efficacy and safety of coiling such aneurysms remains to be determined in larger prospective series.
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. Electronic address: jwjdoctor@sina.com.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Ji
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China; Department of Neurosurgery, Beijing Luhe Hospital, Capital Medical University, China. Electronic address: kanghuibindoctor@163.com.
authors.forename: Huibin
authors.initials: H
authors.lastname: Kang
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. Electronic address: liuaihuadoctor@163.com.
authors.forename: Aihua
authors.initials: A
authors.lastname: Liu
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. Electronic address: liyouxiang_ttyy@126.com.
authors.forename: Youxiang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. Electronic address: 627440730@qq.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. Electronic address: 370453167@qq.com.
authors.forename: Zenghui
authors.initials: Z
authors.lastname: Qian
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. Electronic address: 371357547@qq.com.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Wen
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. Electronic address: 841700194@qq.com.
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. Electronic address: jiangchuhan_ttyy@126.com.
authors.forename: Chuhan
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. Electronic address: 1053157367@qq.com.
authors.forename: Xinjian
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. Electronic address: wuzhongxue_yjs@126.com.
authors.forename: Zhongxue
authors.initials: Z
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
keywords: Coiling; Intracranial aneurysm; Stent; Very small; Wide-necked