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J Neuroradiol. 2014 Dec;41(5):322-8. doi: 10.1016/j.neurad.2014.01.001. Epub 2014 Jan 23.

Stent-assisted coiling of unruptured intracranial aneurysms: long-term follow-up in 164 patients with 183 aneurysms.

Author information

1
Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, 808, route de Lennik, 1070 Brussels, Belgium. Electronic address: benjamin_mine@me.com.
2
Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, 808, route de Lennik, 1070 Brussels, Belgium.

Abstract

PURPOSE:

Stent-assisted coiling (SAC) is increasingly used to treat complex unruptured intracranial aneurysms (UIA) including wide-necked and fusiform IA. However, few data are available over the long-term results of this technique. We report our 9-year-experience of SAC of UIA.

METHODS:

A retrospective review of our prospectively maintained database identified all patients treated by SAC for an UIA in 2 institutions. The clinical charts, procedural data and angiographic results were reviewed.

RESULTS:

Between 2004 and 2012, we identified 164 patients with 183 UIA. There were 115 women and 49 men with a mean age of 46 years. Embolization was successful in all patients. Procedural morbidity and mortality rates were 2.2% and 0% respectively. Immediate anatomical outcome included 54 complete occlusion (29.5%), 43 neck remnants (23.5%) and 86 incomplete occlusions (47%). Imaging follow-up was available in 137 patients (mean=26 months, range 3 to 99 months) and it showed 104 complete occlusions (75.9%), 23 neck remnants (16.8%) and 10 incomplete occlusions (7.3%). At follow-up, only 3 patients developed a significant intrastent stenosis, one of which was induced by radiosurgery. One of these patients had a symptomatic thrombo-embolic complication 3 years after stent placement.

CONCLUSION:

SAC of complex UIA is effective and associated with low complication rates. Even if immediate anatomical results are relatively unsatisfying, mid- and long-term follow-up show a major improvement with a high rate of adequate occlusion that is stable over time. Moreover, the long-term clinical and angiographic tolerance of intracranial stents is excellent.

KEYWORDS:

Endovascular procedure; Intracranial aneurysm; Stent-assisted coiling

PMID:
24462257
DOI:
10.1016/j.neurad.2014.01.001
[Indexed for MEDLINE]

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