Rescue Stenting Using Neuroform Atlas Stent During Coiling Protrusion for Ruptured Intracranial Aneurysms.

Abstract

BACKGROUND:

Endovascular coiling is generally considered as an effective treatment option for ruptured intracranial aneurysms. Increasing operator experience and quality of tools determined an improvement of endovascular cerebral aneurysms' treatment. However, procedure-related complications still occur. The purpose of this study is to report a series of rescue stenting procedures with the Neuroform Atlas (NA) open-cell stent, for intraprocedural complications during coil embolization in patients with ruptured intracranial aneurysms.

METHODS:

Between April 2016 and January 2018, 12 consecutive coil protrusions that occurred during ruptured aneurysms' embolizations were rescued using NA stenting together with tirofiban therapy. Follow-up was performed with initial magnetic resonance angiography (MRA) at 1 month and then MRA plus standard digital subtraction angiography at 11-13 months after the procedure.

RESULTS:

Technical success was achieved in 100% of patients. No NA stent delivery/deployment complication occurred. Initial MRA showed complete occlusion of the aneurysm, with evidence of blood flow into parent vessels in 12 out of 12 cases. At 11-13 months, MRA and digital subtraction angiography showed 10 complete occlusion cases and 1 partial occlusion case. At 2 months, 1 death occurred due to subarachnoid hemorrhage.

CONCLUSIONS:

The open-cell NA stent represents a rescue option for coil protrusion during endovascular treatment of ruptured intracranial aneurysms allowing regular restoration of blood flow and minimizing thromboembolic events.

• Authors: Vittorio Semeraro, Maria Porzia Ganimede, Nicola Maria Lucarelli, Emilio Lozupone, Sofia Vidali, Vito Gisone, Nicola Burdi
• Journal: World neurosurgery (World Neurosurg) Vol. 128 Pg. e454-e460 (Aug 2019) ISSN: 1878-8769 [Electronic] United States
• PMID: 31051305 (Publication Type: Journal Article)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aneurysm, Ruptured (surgery)
• Angiography, Digital Subtraction
• Cerebral Angiography
• Endovascular Procedures (methods)
• Female
• Humans
• Intracranial Aneurysm (surgery)
• Intraoperative Complications (surgery)
• Magnetic Resonance Angiography
• Male
• Middle Aged
• Stents
• Subarachnoid Hemorrhage (surgery)
• Treatment Outcome