Multiple overlapping stent-assisted coiling of complex aneurysms: a single-center experience.

Abstract

OBJECTIVES:

Coil embolization of wide-necked and fusiform aneurysms is challenging and is frequently associated with recanalization despite assistance of any additional device. The purpose of this study was to evaluate the feasibility and mid-term outcomes of complex aneurysms after multiple overlapping stent-assisted coiling (OSAC).

METHODS:

We retrospectively evaluated 26 wide-necked and fusiform atherosclerotic or dissecting aneurysms that were treated with multiple OSAC. Eight aneurysms (30·8%) presented with subarachnoid hemorrhage and one (3·9%) with intracranial hemorrhage.

RESULTS:

Complete embolization was achieved in 15 of the 26 aneurysms (57·7%), while remnant neck was identified in nine (34·6%) and remnant aneurysm was noted in two (7·7%). Immediate procedure-related complications were observed in five patients (19·2%) including two with asymptomatic in-stent thrombosis, one with transient right-sided weakness, one with decreased mentality, and one with aphasia and quadriplegia. A procedure-related permanent neurologic deficit (modified Rankin scale scores of 1 and 5) was noted in two patients (7·7%). Angiographic follow-up (mean duration 23·9 months) after OSAC was carried out in 18 patients (69·2%): 11 (61·1%) were stable, 3 (16·7%) improved, 3 (16·7%) had minor compaction, and 1 had major recanalization (5·5%). One recurred aneurysm after OSAC and two recanalized aneurysms after single stenting were re-treated using additional stent-assisted coiling, and there was no recanalization in these three aneurysms during the 25·7 months after re-treatment.

CONCLUSIONS:

Multiple OSAC is feasible and effective for complex aneurysms and recurrent aneurysms after stent-assisted coiling.

• Authors: Yu Sam Won, Yu Sam Yon, Myung Ho Rho, Eun Chul Chung, Hyun Pyo Hong, Sae Yung Kim, Hee Jin Park, Yoon Jung Choi, So Yeon Lee, Chun Sik Choi, Yon Kwon Ihn
• Journal: Neurological research (Neurol Res) Vol. 37 Issue 3 Pg. 189-96 (Mar 2015) ISSN: 1743-1328 [Electronic] England
• PMID: 25213599 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aortic Dissection (pathology, therapy)
• Angiography
• Embolization, Therapeutic (adverse effects, instrumentation, methods)
• Feasibility Studies
• Female
• Follow-Up Studies
• Humans
• Intracranial Aneurysm (pathology, therapy)
• Intracranial Arteriosclerosis (pathology, therapy)
• Male
• Middle Aged
• Retreatment
• Retrospective Studies
• Stents (adverse effects)
• Subarachnoid Hemorrhage (pathology, therapy)