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AJNR - American Journal of Neuroradiology

Published ahead of print on April 24, 2008
doi: 10.3174/ajnr.A1096

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American Journal of Neuroradiology 29:1395-1400, August 2008
© 2008 American Society of Neuroradiology

INTERVENTIONAL

The Feasibility and Efficacy of Treatment with a Willis Covered Stent in Recurrent Intracranial Aneurysms after Coiling

M.-H. Li, Y.-Q. Zhu, C. Fang, W. Wang, P.-L. Zhang, Y.-S. Cheng, H.-Q. Tan and J.-B. Wang

From the Department of Diagnostic and Interventional Radiology, Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, China

Please address correspondence to Yue-Qi Zhu, No. 600, Yi Shan Rd, Shanghai, 200233, China; e-mail: zhuyueqi{at}hotmail.com

BACKGROUND AND PURPOSE: Aneurysm recurrence is an innate problem after coiling, and the recurrence rate is higher in complicated aneurysms. We evaluated the feasibility and efficacy of using the Willis covered stent in treating recurrent aneurysms after coil embolization.

MATERIALS AND METHODS: Eight aneurysms in 8 patients treated with detachable coils had confirmed recurrent aneurysms: 3 giant, 1 large, 1 dissecting, and 3 small wide-necked. The recurrent aneurysms involved C3 in 1 patient, C4 in 1, C7 in 5, and V4 in 1. A total of 11 covered stents were implanted into 8 target arteries. Follow-up angiography was performed 1–16 months after the procedure. Clinical follow-up data were collected and retrospectively analyzed, grading as fully recovered, improved, unchanged, or aggravated.

RESULTS: Willis covered stent placement succeeded technically in all of the aneurysms. No technique-related adverse event occurred. Total occlusion was achieved immediately in 6 aneurysms, and a small endoleak was observed in 2 aneurysms. No mortality or morbidity occurred during or after the procedures, including during the follow-up period. Follow-up angiograms revealed that all 8 of the recurrent aneurysms were completely isolated, and 8 parent vessels kept patency, except 1 with mild stenosis. Clinical neurologic symptoms fully resolved in 5 patients, improved in 1, and were unchanged in 2 at the end of the follow-up period.

CONCLUSIONS: In this small study with a middle-term follow-up, the Willis covered stent was used safely and effectively to occlude recurred aneurysms after coiling. Longer-term follow-up and additional clinical experience are needed to fully determine the safety and efficacy of the device.

This article has been cited by other articles:

				Y-D Li, M-H Li, B-L Gao, C Fang, Y-S Cheng, W Wang, W-B Li, J-G Zhao, P-L Zhang, J Wang, et al. Endovascular treatment of recurrent intracranial aneurysms with re-coiling or covered stents J. Neurol. Neurosurg. Psychiatry, January 1, 2010; 81(1): 74 - 79. [Abstract] [Full Text] [PDF]

				M.-H. Li, Y.-D. Li, H.-Q. Tan, Q.-Y. Luo, and Y.-S. Cheng Treatment of Distal Internal Carotid Artery Aneurysm with the Willis Covered Stent: A Prospective Pilot Study Radiology, November 1, 2009; 253(2): 470 - 477. [Abstract] [Full Text] [PDF]