J Cerebrovasc Endovasc Neurosurg.  2013 Sep;15(3):158-163. 10.7461/jcen.2013.15.3.158.

Clinical and Angiographic Outcomes of Wide-necked Aneurysms Treated with the Solitaire AB Stent

Affiliations
  • 1Department of Neurosurgery, Cerebro-vascular Center, Bongseng Memorial Hospital, Busan, Korea. drkschae@gmail.com

Abstract


OBJECTIVE
This study investigated the clinical and angiographic outcomes of treatment with stent-assisted coil embolization using the Solitaire AB stents for wide-necked intracranial aneurysms.
METHODS
From October 2010 to December 2011, 22 patients with aneurysms were treated with the Solitaire AB stent. One patient with a dissecting aneurysm was excluded, thus 21 patients with 21 wide-necked saccular aneurysms were included in this study. The technical success rate, procedure-related complications, initial and follow-up angiographic results, and clinical outcomes were retrospectively collected.
RESULTS
The locations of aneurysms were as follows: paraclinoid in 14, distal internal carotid artery in 4, and vertebral artery in 3 patients. All aneurysms were unruptured and less than 10 mm-sized. The mean dome-to-neck ratio of the aneurysms was 1.00 (range: 0.45-1.81). The mean follow-up duration was 12.1 (7-15) months after the initial procedure. The technical success rate was 21 (95.5%) of 22 patients with aneurysms. Fortunately, there were no procedure-related complications. Follow-up angiography showed that the rate of complete occlusion was 57.1%, neck remnants 38.1%, and incomplete occlusion 4.8%.
CONCLUSION
We suggest that using Solitaire AB stent is technically feasible and safe in the stent-assisted coil embolization for wide-necked saccular intracranial aneurysms. To evaluate the long-term effects of this stent, further follow-up angiography is needed.

Keyword

Solitaire stent; Coil embolization; Wide-necked aneurysm

MeSH Terms

Aneurysm
Aneurysm, Dissecting
Angiography
Carotid Artery, Internal
Follow-Up Studies
Humans
Intracranial Aneurysm
Neck
Retrospective Studies
Stents
Vertebral Artery

Figure

  • Fig. 1 Patient No. 11: A 60-year-old woman with unruptured aneurysm of a tortuous left distal internal carotid artery (ICA) is treated with coil embolization. (A) The aneurysm is shown on left ICA angiography. (B) A Solitaire stent is positioned at the left distal ICA (white arrow: proximal and distal stent marker). (C) Immediate left ICA angiography after embolization shows no contrast filling of the aneurysmal neck or dome. (D) Twelve months after embolization, angiography shows no recanalization.

  • Fig. 2 Patient No.8: A 55-year-old woman with an unruptured aneurysm of the left distal internal carotid artery (ICA) was treated with coil embolization by repositioning the stent. (A) ICA angiography shows that the stent marker was outside the vessel. (B) The stent was pulled out slightly and the stent marker was moved back inside the vessel.


Cited by  4 articles

Clinical and Angiographic Outcomes of Aneurysms Treated with Two Self-expanding Stent-assisted Coiling Systems: A Comparison of Solitaire AB and Enterprise VRD Stents
Sung-Won Kim, Seng-Oun Sung, Kil-Sung Chae, Hwa-Seung Park, Sang-Hoon Lee
J Cerebrovasc Endovasc Neurosurg. 2015;17(3):149-156.    doi: 10.7461/jcen.2015.17.3.149.

Outcomes of Stent-assisted Coil Embolization of Wide-necked Intracranial Aneurysms Using the Solitaire™ AB Neurovascular Remodeling Device
Hae Woong Jeong, Won-Bae Seung
J Cerebrovasc Endovasc Neurosurg. 2015;17(4):301-312.    doi: 10.7461/jcen.2015.17.4.301.

Comparison of Long-Term Angiographic Results of Wide-Necked Intracranial Aneurysms : Endovascular Treatment with Single-Microcatheter Coiling, Double-Microcatheter Coiling, and Stent-Assisted Coiling
Hyun Sik Kim, Byung Moon Cho, Chan Jong Yoo, Dae Han Choi, Dong Keun Hyun, Yu Shik Shim, Joon Ho Song, Jae Keun Oh, Jun Hyong Ahn, Ji Hee Kim, In Bok Chang
J Korean Neurosurg Soc. 2021;64(5):751-762.    doi: 10.3340/jkns.2021.0010.

Angiographic Results of Wide-Necked Intracranial Aneurysms Treated with Coil Embolization : A Single Center Experience
Joon Ho Song, In Bok Chang, Jun Hyong Ahn, Ji Hee Kim, Jae Keun Oh, Byung Moon Cho
J Korean Neurosurg Soc. 2015;57(4):250-257.    doi: 10.3340/jkns.2015.57.4.250.


Reference

1. Fargen KM, Hoh BL, Welch BG, Pride GL, Lanzino G, Boulos AS, et al. Long-term results of enterprise stent-assisted coiling of cerebral aneurysms. Neurosurgery. 2012; 8. 71(2):239–244. discussion 244. PMID: 22472556.
Article
2. Ferrell AS, Golshani K, Zomorodi A, Smith TP, Britz GW. Improved delivery of the Neuroform 3 stent: Technical note. J Neurointerv Surg. 2012; 7. 4(4):287–290. PMID: 21990486.
Article
3. Fiorella D, Albuquerque FC, Deshmukh VR, McDougall CG. Usefulness of the Neuroform stent for the treatment of cerebral aneurysms: Results at initial (3-6-mo) follow-up. Neurosurgery. 2005; 6. 56(6):1191–1201. discussion 1201-2. PMID: 15918935.
Article
4. Fiorella D, Albuquerque FC, Woo H, Rasmussen PA, Masaryk TJ, McDougall CG. Neuroform in-stent stenosis: Incidence, natural history, and treatment strategies. Neurosurgery. 2006; 7. 59(1):34–42. discussion 34-42. PMID: 16823298.
Article
5. Gu DQ, Zhang X, Luo B, Long XA, Duan CZ. The effect of Neuroform stent-assisted coil embolization of wide-necked intracranial aneurysms and clinical factors on progressive aneurysm occlusion on angiographic follow-up. J Clin Neurosci. 2013; 2. 20(2):244–247. PMID: 23201094.
Article
6. Hong B, Patel NV, Gounis MJ, DeLeo MJ 3rd, Linfante I, Wojak JC, et al. Semi-jailing technique for coil embolization of complex, wide-necked intracranial aneurysms. Neurosurgery. 2009; 12. 65(6):1131–1138. discussion 1138-9. PMID: 19934972.
Article
7. Izar B, Rai A, Raghuram K, Rotruck J, Carpenter J. Comparison of devices used for stent-assisted coiling of intracranial aneurysms. PLoS one. 2011; 6(9):e24875. PMID: 21966374.
Article
8. Klisch J, Clajus C, Sychra V, Eger C, Strasilla C, Rosahl S, et al. Coil embolization of anterior circulation aneurysms supported by the Solitaire AB Neurovascular Remodeling Device. Neuroradiology. 2010; 5. 52(5):349–359. PMID: 19644683.
Article
9. Kwon HJ, Kwon Y. Embolization of cerebral aneurysms with stent and detachable platinum coils-Single center experience. J Korean Soc Intravasc Neurosurg. 2006; 1:1–6.
10. Lee JI, Ko JK, Choi BK, Choi CH. In-stent stenosis of stent-assisted coil embolization of the supraclinoid internal carotid artery aneurysm. J Korean Neurosurg Soc. 2012; 6. 51(6):370–373. PMID: 22949968.
Article
11. Lee SJ, Cho YD, Kang HS, Kim JE, Han MH. Coil embolization using the self-expandable closed-cell stent for intracranial saccular aneurysm: A single-center experience of 289 consecutive aneurysms. Clin Radiol. 2013; 3. 68(3):256–263. PMID: 23017739.
Article
12. Lylyk P, Ferrario A, Pasbon B, Miranda C, Doroszuk G. Buenos Aires experience with the Neuroform self-expanding stent for the treatment of intracranial aneurysms. J Neurosurg. 2005; 2. 102(2):235–241. PMID: 15739550.
Article
13. Maldonado IL, Machi P, Costalat V, Mura T, Bonafe A. Neuroform stent-assisted coiling of unruptured intracranial aneurysms: Short- and midterm results from a single-center experience with 68 patients. AJNR Am J Neuroradiol. 2011; 1. 32(1):131–136. PMID: 20966053.
Article
14. Santillan A, Greenberg E, Patsalides A, Salvaggio K, Riina HA, Gobin YP. Long-term clinical and angiographic results of Neuroform stent-assisted coil embolization in wide-necked intracranial aneurysms. Neurosurgery. 2012; 5. 70(5):1232–1237. discussion 1237. PMID: 22095221.
Article
15. Wakhloo AK, Mandell J, Gounis MJ, Brooks C, Linfante I, Winer J, et al. Stent-assisted reconstructive endovascular repair of cranial fusiform atherosclerotic and dissecting aneurysms: Long-term clinical and angiographic follow-up. Stroke. 2008; 12. 39(12):3288–3296. PMID: 18772450.
16. Wanke I, Doerfler A, Schoch B, Stolke D, Forsting M. Treatment of wide-necked intracranial aneurysms with a self-expanding stent system: Initial clinical experience. AJNR Am J Neuroradiol. 2003; Jun-Jul. 24(6):1192–1199. PMID: 12812954.
17. Yavuz K, Geyik S, Pamuk AG, Koc O, Saatci I, Cekirge HS. Immediate and midterm follow-up results of using an electrodetachable, fully retrievable SOLO stent system in the endovascular coil occlusion of wide-necked cerebral aneurysms. J Neurosurg. 2007; 7. 107(1):49–55. PMID: 17639873.
Article
18. Yoon PH, Ahn JY, Kim SH, Choi EW. Endovascular treatment of wide-necked aneurysms with a stent and detachable coils. Korean J Cerebrovasc Neurosurg. 2004; 1. 6(1):31–37.
19. Zhang J, Lv X, Yang J, Wu Z. Stent-assisted coil embolization of intracranial aneurysms using Solitaire stent. Neurol India. 2012; May-Jun. 60(3):278–282. PMID: 22824683.
Article
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