Stent placement in the endovascular treatment of intracranial aneurysms. Swiss medical weekly : official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology [Swiss Med Wkly] Journal article | | Title | Stent placement in the endovascular treatment of intracranial aneurysms. | | Author(s) | Mordasini P, Walser A, Gralla J, Wiest R, Ozdoba C, Reinert M, Schroth G | | Institution | Institute of Diagnostic and Interventional Neuroradiology, University Hospital Inselspital, Berne, Switzerland. gerhard.schroth@insel.ch. | | Source | Swiss Med Wkly 2008 Nov 1; 138(43-44):646-54. | | Abstract | OBJECTIVE: To analyze the immediate and midterm angiographic and clinical results of stent placement in the endovascular treatment of intracranial cerebral aneurysms.
METHODS: Out of 330 cerebral aneurysms treated by endovascular approach in our neurovascular centre, stents have been used in 18 patients. Twelve aneurysms (66.7%) were acutely ruptured, four (22.2%) were unruptured, two (11.1%) were recanalized after initial coiling. In three patients (16.7%) stent placement was used for revascularization of acute vessel thrombosis during coiling. Angiographic follow-up was obtained in 13 (72.2%) patients (mean 1.8 years, range 0.4-6.6) and clinical follow-up in 13 (72.2%) patients (mean 2.0 years, range 0.2-6.6).
RESULTS: Complete occlusion was achieved in eight (44.4%) patients, a neck-remnant remained in four (22.2%) and an incomplete occlusion in four (22.2%). In the two cases of previously treated aneurysms a neck-remnant remained after secondary stent-assisted coiling. In four cases thromboembolic events resulted in a transient procedure related morbidity. No permanent procedure related morbidity or mortality was observed. One case of an asymptomatic late in-stent stenosis occurred. On clinical followup modified Ranking Score was 0 in 3 patients (23.1%), 1 in 3 patients (23.1%) and 2-3 in 7 patients (53.9%). On angiographic follow-up recanalisation was observed in 5 (38.5% = 5/13) aneurysms.
CONCLUSION: Even in acutely ruptured aneurysms, stent assisted coiling can be a relatively effective and safe treatment for cerebral aneurysms. One asymptomatic in-stent stenosis occurred indicating that the risk rate of restenosis seems to be lower compared to stent deployment in atherosclerotic lesions, where restenosis rates up to 30% are described. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19005870 |
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