Two cases of acutely ruptured
cerebral aneurysm of low dome/neck ratio treated by
stent-assisted GDC embolization using balloon-expandable coronary
stent, and also their long-term follow-up results are reported. After embolization, the basilar trunk
aneurysm was completely occluded, and partial occlusion was obtained for the internal carotid (IC)-paraclinoid
aneurysm. Oral ticropidine (200 mg/day) was given after the embolization, and no neurological events were seen during long-term follow-up (64-68 months). Follow-up angiograms of the basilar trunk
aneurysm at 20 months showed complete occlusion and no in-
stent stenosis. Follow-up angiograms of the IC-paraclinoid
aneurysm at 52 months showed complete occlusion of the
aneurysm, but mild
stenosis at the distal end of the
stent graft. These cases suggested that
stent-assisted GDC embolization is effective for prevention of rebleeding from
ruptured aneurysm during long-term observation even with sufficient dose of antiplatelets
therapy. Caution should be taken on aneurysmal recanalization and parent artery
stenosis due to
stent deployment during long-term period.