title: Stent-assisted coiling embolization of tiny, wide-necked intracranial aneurysms.
abstract: Tiny, wide-necked intracranial aneurysms pose a significant therapeutic challenge for interventional neuroradiologists because of the small volume for microcatheterization and coil stabilization inside the aneurysm sac. We report our preliminary experience of stent-assisted coiling embolization of these aneurysms.
  
  
  
  A total of 50 patients with 52 tiny, wide-necked aneurysms who were treated with stent-assisted coiling from January 2007 to December 2014 were reviewed retrospectively. Baseline characteristics, procedure-related complications, angiographic follow-up results and clinical outcomes were statistically analyzed.
  
  
  
  All aneurysms were successfully treated with the stent-assisted coiling technique, and at the end of the procedure, aneurysm occlusion was complete for 45 (86.5 %), near complete for 3 (5.8 %) and incomplete for 4 (7.7 %). Procedural complications (1 intraprocedural rupture, 2 coil migrations and 1 aneurysm re-rupture) occurred in 4 (8 %) of 50 patients, resulting in permanent morbidity in 1 (2 %) patient and death in 1 (2 %) patient. Follow-up imaging was available in 43 (84.3 %) aneurysms for 6-31 months (mean, 13 months). Complete occlusion was achieved in 40 (93 %) of 43 aneurysms on long-term follow-up. One aneurysm with complete occlusion and one with incomplete occlusion after the initial embolization developed a significant recurrence (4.7 %). Clinical follow-up was available for 43 (86 %) of 50 patients at a mean of 36.7 months (range 15-66 months). Of these 43 patients, 42 (97 %) made an excellent recovery achieving a GOS of 5. None of the patients died or experienced re-bleeding or ischemic cerebral vascular events during follow-up.
  
  
  
  Stent-assisted coiling embolization is feasible and relatively safe for tiny, wide-necked intracranial aneurysms of carotid arteries. Furthermore, long-term follow-up angiography indicated stent-assisted coiling seems to be effective in preventing early recanalization.
authors.affiliation: Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, 200040, China.
authors.forename: Yongtao
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, 200040, China.
authors.forename: Yanbing
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Neurosurgery, Second People Hospital, Taizhou, China.
authors.forename: Dajun
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, 200040, China.
authors.forename: Yingjun
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, 200040, China.
authors.forename: Yanlong
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Middle Road, Shanghai, 200040, China. lengbing99999@126.com.
authors.forename: Bing
authors.initials: B
authors.lastname: Leng
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D015607:Stents
keywords: Complication; Recanalization; Stent-assisted coiling; Tiny intracranial aneurysm