Coil embolization using the self-expandable closed-cell stent for intracranial saccular aneurysm: A single-center experience of 289 consecutive aneurysms
Introduction
Since the International Subarachnoid Aneurysm Trial (ISAT), endovascular coil embolization has been widely used for treatment of intracranial aneurysms. Improved devices and advanced coiling techniques have made it possible to treat more aneurysms with difficult configurations. Among them, the stent protection technique has significantly widened the applicability of endovascular therapy of intracranial aneurysms to a greater extent.1 Although development of a self-expandable stent accelerated the popularity of this technique due to easy navigation and delivery, only a few studies of Enterprise Vascular Reconstruction Device (Enterprise stent, Codman, Raynhan, MA, USA) use for the treatment of aneurysms have been reported. Therefore, the present study was undertaken to describe the clinical and radiological results of coil embolization for intracranial saccular aneurysms using the Enterprise stent.
Section snippets
Patient population
From June 2008 to August 2011, endovascular treatment was performed in 1160 patients with 1326 intracranial aneurysms. Over the same period, 261 patients (65 men, 196 women; mean age 60.0 ± 9.8 years) with a total of 289 saccular aneurysms underwent coil embolization using the Enterprise stent. Patients with dissecting, fusiform, blood blister-like, or false aneurysms were excluded from the study. Therapeutic alternatives were discussed between the neurosurgical and neuro-interventional teams
Procedural results
The Enterprise stent was most frequently used in internal carotid artery aneurysms (n = 103, 35.6%; Fig 1), followed by the anterior communicating artery (n = 57, 19.7%) and the middle cerebral artery aneurysms (n = 51, 17.6%).
Among the 289 saccular aneurysms, total occlusion was achieved in 20 aneurysms, near-total occlusion in 185, and subtotal occlusion in 84 through endovascular coiling using the Enterprise stent. Y-configured stenting was applied in six cases, staged double stenting in
Discussion
Since Higashida et al.3 reported their experience with stent-assisted coiling of intracranial aneurysms in five patients, a few clinical studies have been published regarding the Enterprise stent protection technique (Table 3).1, 3, 4, 5, 6, 7, 8, 9 However, the populations were too small to estimate the efficacy and safety of the stent in the previous studies. Mocco et al.5 reported the results of the stent for 142 aneurysms, but they did not include the follow-up results. The present study
Acknowledgements
This study was supported by Ministry of Health and Welfare, Republic of Korea (A110894).
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