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Swiss Med Wkly. 2008 Nov 1;138(43-44):646-54. doi: 2008/43/smw-12396.

Stent placement in the endovascular treatment of intracranial aneurysms.

Author information

1
Institute of Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, Berne, Switzerland.

Abstract

OBJECTIVE:

To analyze the immediate and midterm angiographic and clinical results of stent placement in the endovascular treatment of intracranial cerebral aneurysms.

METHODS:

Out of 330 cerebral aneurysms treated by endovascular approach in our neurovascular centre, stents have been used in 18 patients. Twelve aneurysms (66.7%) were acutely ruptured, four (22.2%) were unruptured, two (11.1%) were recanalized after initial coiling. In three patients (16.7%) stent placement was used for revascularization of acute vessel thrombosis during coiling. Angiographic follow-up was obtained in 13 (72.2%) patients (mean 1.8 years, range 0.4-6.6) and clinical follow-up in 13 (72.2%) patients (mean 2.0 years, range 0.2-6.6).

RESULTS:

Complete occlusion was achieved in eight (44.4%) patients, a neck-remnant remained in four (22.2%) and an incomplete occlusion in four (22.2%). In the two cases of previously treated aneurysms a neck-remnant remained after secondary stent-assisted coiling. In four cases thromboembolic events resulted in a transient procedure related morbidity. No permanent procedure related morbidity or mortality was observed. One case of an asymptomatic late in-stent stenosis occurred. On clinical followup modified Ranking Score was 0 in 3 patients (23.1%), 1 in 3 patients (23.1%) and 2-3 in 7 patients (53.9%). On angiographic follow-up recanalisation was observed in 5 (38.5% = 5/13) aneurysms.

CONCLUSION:

Even in acutely ruptured aneurysms, stent assisted coiling can be a relatively effective and safe treatment for cerebral aneurysms. One asymptomatic in-stent stenosis occurred indicating that the risk rate of restenosis seems to be lower compared to stent deployment in atherosclerotic lesions, where restenosis rates up to 30% are described.

PMID:
19005870
DOI:
2008/43/smw-12396
[Indexed for MEDLINE]

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