Advanced

AJNR - American Journal of Neuroradiology

Published ahead of print on May 20, 2009
doi: 10.3174/ajnr.A1618

This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1618v1 30/8/1502    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Huang, Q. Articles by Liu, J. PubMed PubMed Citation Articles by Huang, Q. Articles by Liu, J.

American Journal of Neuroradiology 30:1502-1506, September 2009
© 2009 American Society of Neuroradiology

INTERVENTIONAL

Stent-Assisted Embolization of Wide-Neck Anterior Communicating Artery Aneurysms: Review of 21 Consecutive Cases

Q. Huang^a, Y. Xu^a, B. Hong^a, R. Zhao^a, W. Zhao^a and J. Liu^a

^aFrom the Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.

Please address correspondence to Jianmin Liu, MD, Director and Professor, Department of Neurosurgery, Changhai Hospital, Changhai Hospital, Changhai Rd 168, Shanghai 200433, China; e-mail: liu118{at}vip.163.com

BACKGROUND AND PURPOSE: Anterior communicating artery (AcomA) aneurysm is the most frequent form of aneurysm. Stent placement is particularly difficult and of limited use for AcomA aneurysms. We report our experience with stent-assisted embolization for wide-neck AcomA aneurysms in 21 patients. Particular attention is given to the morphologic characteristics and strategy of stent deployment.

MATERIALS AND METHODS: Between January 2005 and February 2008, stent-assisted coiling was performed in 21 patients with wide-neck AcomA aneurysms. Patient demographics, aneurysm morphology, procedures, and clinical and angiographic outcomes were retrospectively reviewed.

RESULTS: Successful deployment of the stent in the targeted artery was achieved in all patients. Nineteen Neuroform 2 or Neuroform 3 stents and 2 LEO stents were used. The distal segment of the stent was positioned in the ipsilateral A2 in 12 patients, in the contralateral A2 across the AcomA in 5 patients, and into the aneurysm sac in 4 patients. Complete occlusion was achieved in 18 patients; near-complete occlusion, in 2 patients; and partial occlusion, in 1 patient. Intraoperative perforation of the aneurysm developed in 1 patient, which was secured by subsequent coiling. Angiographic follow-up in 12 patients for 6.9 months showed 1 recanalization and no in-stent stenosis.

CONCLUSIONS: Our preliminary results suggest that stent-assisted embolization for wide-neck AcomA aneurysms is technically feasible and safe. Further follow-up is needed for long-term efficacy of stent placement.