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Neuroform Stent−Assisted Coiling of Unruptured Intracranial Aneurysms: Short- and Midterm Results from a Single-Center Experience with 68 Patients

Neuroform Stent−Assisted Coiling of Unruptured Intracranial Aneurysms: Short- and Midterm Results... BACKGROUND AND PURPOSE: Intracranial stent placement assists in the coiling of wide-neck aneurysms and aids in reconstructing and protecting the parent artery. In this study, we analyze our experience in the use of the Neuroform system. MATERIALS AND METHODS: Records of patients treated with a Neuroform stent from June 2003 to September 2007 were retrieved from a data base for analysis of population characteristics, occurrence of complications, and acute and midterm angiographic results. RESULTS: Sixty-eight patients harboring 76 aneurysms located primarily in the anterior circulation were treated. There were 5 cases (6.6%) of clot formation after deployment (1 with a permanent neurologic deficit), 1 case of perioperative stent displacement with hemorrhage, and 5 cases (6.6%) of transient neurologic deficit due to thromboembolic events. The morbidity-mortality rate at discharge was 2.9%. One patient presented with a delayed in-stent thrombosis, and 3 others, with silent stenosis. Twenty-four aneurysms (31.6%) were completely occluded in the initial embolization. However, a marked increase in the occlusion rate was observed, with 44 of the 68 aneurysms (64.7%) examined at the 18-month follow-up and 26 of the 46 aneurysms (56.5%) examined in the 3-year follow-up presenting with complete occlusion. At the end of the study, a neck remnant was present in 6 aneurysms (13%) and a residual sac, in 7 (15.2%). Mean follow-up time was 25.7 months. CONCLUSIONS: The present series demonstrates the relative safety and feasibility of the Neuroform stent−assisted coiling technique, which seems to provide better results over coiling alone for wide-neck aneurysms. Angiographic results improve with time due to progressive thrombosis of the aneurysm. Abbreviations ASA aspirin CI confidence interval D largest aneurysm diameter DSA digital subtraction angiography GDC Guglielmi detachable coil ICA internal carotid artery MCA middle cerebral artery MRA MR angiography OR odds ratio PICA posterior inferior cerebellar artery http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Neuroform Stent−Assisted Coiling of Unruptured Intracranial Aneurysms: Short- and Midterm Results from a Single-Center Experience with 68 Patients

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2011 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2245
pmid
20966053
Publisher site
See Article on Publisher Site

Abstract

BACKGROUND AND PURPOSE: Intracranial stent placement assists in the coiling of wide-neck aneurysms and aids in reconstructing and protecting the parent artery. In this study, we analyze our experience in the use of the Neuroform system. MATERIALS AND METHODS: Records of patients treated with a Neuroform stent from June 2003 to September 2007 were retrieved from a data base for analysis of population characteristics, occurrence of complications, and acute and midterm angiographic results. RESULTS: Sixty-eight patients harboring 76 aneurysms located primarily in the anterior circulation were treated. There were 5 cases (6.6%) of clot formation after deployment (1 with a permanent neurologic deficit), 1 case of perioperative stent displacement with hemorrhage, and 5 cases (6.6%) of transient neurologic deficit due to thromboembolic events. The morbidity-mortality rate at discharge was 2.9%. One patient presented with a delayed in-stent thrombosis, and 3 others, with silent stenosis. Twenty-four aneurysms (31.6%) were completely occluded in the initial embolization. However, a marked increase in the occlusion rate was observed, with 44 of the 68 aneurysms (64.7%) examined at the 18-month follow-up and 26 of the 46 aneurysms (56.5%) examined in the 3-year follow-up presenting with complete occlusion. At the end of the study, a neck remnant was present in 6 aneurysms (13%) and a residual sac, in 7 (15.2%). Mean follow-up time was 25.7 months. CONCLUSIONS: The present series demonstrates the relative safety and feasibility of the Neuroform stent−assisted coiling technique, which seems to provide better results over coiling alone for wide-neck aneurysms. Angiographic results improve with time due to progressive thrombosis of the aneurysm. Abbreviations ASA aspirin CI confidence interval D largest aneurysm diameter DSA digital subtraction angiography GDC Guglielmi detachable coil ICA internal carotid artery MCA middle cerebral artery MRA MR angiography OR odds ratio PICA posterior inferior cerebellar artery

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Jan 1, 2011

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