J Korean Neurosurg Soc.  2019 Jan;62(1):27-34. 10.3340/jkns.2018.0064.

Selective Temporary Stent-Assisted Coil Embolization for Intracranial Wide-Necked Small Aneurysms Using Solitaire AB Retrievable Stent

Affiliations
  • 1Department of Neurosurgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 2Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. nvkumc@gmail.com

Abstract


OBJECTIVE
Stent-assisted coil embolization of intracranial wide-necked aneurysm requires long-term postoperative antiplatelet therapy to prevent in-stent thrombosis. This study aimed to demonstrate results of temporary stent placement for coiling wide necked small intracranial aneurysms, which eliminated need for antiplatelet agents, and to discuss its feasibility and safety.
METHODS
Data of 156 patients who underwent stent-assisted coil embolization between 2011 and 2014 were retrospectively analyzed. Thirteen cases of temporary stent-assisted coil embolization were included, and their clinical and radiological results were evaluated.
RESULTS
The aneurysms treated were all unruptured except one case. All of them had wide neck with mean dome-to-neck ratio of 0.96 and were small-sized aneurysms with mean maximal diameter of 4.2 mm. There was no technical failure in retrieval of stent after completion of embolization of the target aneurysm. Immediate angiography revealed 11 complete and two partial embolization (one residual neck and one residual aneurysm). Two cases encountered thrombosis complication, and they were managed without neurological sequelae. The mean follow-up period was 43 months, angiographic follow-up revealed two cases with minor recurrence, and clinical outcome was good with modified Rankin scale score of 0.
CONCLUSION
Temporary stent-assisted coil embolization of small wide-necked intracranial aneurysm using fully retrievable stent appears safe and effective. Further application and evaluation of this technique in more cases with larger size aneurysm is warranted.

Keyword

Coil; Intracranial aneurysm; Stents

MeSH Terms

Aneurysm*
Angiography
Embolization, Therapeutic*
Follow-Up Studies
Humans
Intracranial Aneurysm
Neck
Platelet Aggregation Inhibitors
Recurrence
Retrospective Studies
Stents*
Thrombosis
Platelet Aggregation Inhibitors
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