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Online ISSN 1827-1847
Peng T., Liu A., Jia J., Li Y., Jiang C., Wu Z., Yang X.
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital Capital Medical University, Beijing, China
Aim: The aim of the study was to present the results of the first prospective analysis of stent-assisted coiling of broad-based cerebral aneurysms.
Methods: Patients with cerebral aneurysms that were broad-based (>4 mm) or had unfavorable dome/neck ratios (<1.5) were enrolled in this study between February 2010 and March 2011 at our center. Aneurysms were treated with the self-expanding neurovascular stents with or without adjunctive coil embolization. All patients underwent clinical evaluation and conventional angiography more than 3 months after treatment. Angiographic results were adjudicated by an experienced neuroradiologist at a nonparticipating site.
Results: One hundred and forty-two patients with 176 intracranial aneurysms (30 men; 19-78 years of age; mean age, 51.3 years) were treated during the study period. A clinical improvement or stable outcome was achieved in 136 patients (95.8%). The 4 cases of permanent morbidity included 2 patients with a paralysis, one patient with hemiparesis due to an acute in-stent thrombosis and another one with aphasia due to an acute in-stent thrombosis too. Two patients died of rehemorrhage after treatment. Angiographic follow-up was available in 114 of the 140 surviving patients (81.4%) at a mean of 8.25 months (range, 3 to 18 months). Recanalization in 10 patients (8.8%) ranging from 3 to 12 months required retreatment in all. No significant in-construct stenosis (≥50%) was identified at follow-up angiography.
Conclusion: Stent-assisted coil embolization is an attractive option for broad-based cerebral aneurysms with a low morbidity and mortality rates. Recanalization observed 3 months after the initial obliteration emphasizes the need for follow-up angiography.