Abstract
BACKGROUND AND PURPOSE: Intracranial stent placement assists in the coiling of wide-neck aneurysms and aids in reconstructing and protecting the parent artery. In this study, we analyze our experience in the use of the Neuroform system.
MATERIALS AND METHODS: Records of patients treated with a Neuroform stent from June 2003 to September 2007 were retrieved from a data base for analysis of population characteristics, occurrence of complications, and acute and midterm angiographic results.
RESULTS: Sixty-eight patients harboring 76 aneurysms located primarily in the anterior circulation were treated. There were 5 cases (6.6%) of clot formation after deployment (1 with a permanent neurologic deficit), 1 case of perioperative stent displacement with hemorrhage, and 5 cases (6.6%) of transient neurologic deficit due to thromboembolic events. The morbidity-mortality rate at discharge was 2.9%. One patient presented with a delayed in-stent thrombosis, and 3 others, with silent stenosis. Twenty-four aneurysms (31.6%) were completely occluded in the initial embolization. However, a marked increase in the occlusion rate was observed, with 44 of the 68 aneurysms (64.7%) examined at the 18-month follow-up and 26 of the 46 aneurysms (56.5%) examined in the 3-year follow-up presenting with complete occlusion. At the end of the study, a neck remnant was present in 6 aneurysms (13%) and a residual sac, in 7 (15.2%). Mean follow-up time was 25.7 months.
CONCLUSIONS: The present series demonstrates the relative safety and feasibility of the Neuroform stent−assisted coiling technique, which seems to provide better results over coiling alone for wide-neck aneurysms. Angiographic results improve with time due to progressive thrombosis of the aneurysm.
Abbreviations
- ASA
- aspirin
- CI
- confidence interval
- D
- largest aneurysm diameter
- DSA
- digital subtraction angiography
- GDC
- Guglielmi detachable coil
- ICA
- internal carotid artery
- MCA
- middle cerebral artery
- MRA
- MR angiography
- OR
- odds ratio
- PICA
- posterior inferior cerebellar artery
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