open access

Vol 50, No 6 (2016)
Original research articles
Submitted: 2015-10-12
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Stent-assisted coiling of very small wide-necked intracranial aneurysms: Complications, anatomical results and clinical outcomes

Wenjun Ji1, Huibin Kang12, Aihua Liu1, Youxiang Li1, Xin Feng1, Zenghui Qian1, Xiaolong Wen1, Wenjuan Xu1, Chuhan Jiang1, Xinjian Yang1, Zhongxue Wu1
DOI: 10.1016/j.pjnns.2016.07.004
·
Neurol Neurochir Pol 2016;50(6):410-417.
Affiliations
  1. Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
  2. Department of Neurosurgery, Beijing Luhe Hospital, Capital Medical University, China

open access

Vol 50, No 6 (2016)
Original research articles
Submitted: 2015-10-12

Abstract

Background and objective

Treatment of very small (≤3mm) wide-necked intracranial aneurysms remains controversial, we investigated the efficacy and safety of stent-assisted coiling of such aneurysms.

Methods

From September 2008 to December 2012, 112 very small wide-necked intracranial aneurysms in 108 patients were embolized with stent-assisted coiling. We assessed the initial neurological conditions, complications and anatomic results. The follow-up results were evaluated with DSA and mRS.

Results

Stent deployment was successful in 104 of 108 procedures (96.3%). 11 complications (10.2%) occurred during procedures, including 5 events of aneurysm rupture, 3 events of thromboembolism. The rate of complication, rupture and thromboembolism was not statistically different between the ruptured and unruptured patients (P=0.452, P=0.369, P=1.000, respectively). The initial aneurysmal occlusion was Raymond scale (RS) 1 in 34 patients (31.5%), RS2 in 53 patients (49.1%), and RS3 in 21 patients (19.4%). 79 aneurysms were available for anatomic follow-up of 12–47 months, stable occlusion in 45 aneurysms (57.0%), progressive complete occlusion in 34 aneurysms (43.0%). 95 patients(88.0%) were available for a clinical follow-up of 12–52 months, 92 patients (96.8%) had favorable clinical outcomes (mRS ≤2), 3 patients (3.2%) had morbidity (mRS: 3–5). The morbidity was not statistically different between the ruptured and unruptured patients (P=1.000).

Conclusions

Stent-assisted coiling of very small wide-necked intracranial aneurysms may be effective and safe. Because of low risk of rupture in such aneurysms, the coiling of unruptured such aneurysms must be selective. The long-term efficacy and safety of coiling such aneurysms remains to be determined in larger prospective series.

Abstract

Background and objective

Treatment of very small (≤3mm) wide-necked intracranial aneurysms remains controversial, we investigated the efficacy and safety of stent-assisted coiling of such aneurysms.

Methods

From September 2008 to December 2012, 112 very small wide-necked intracranial aneurysms in 108 patients were embolized with stent-assisted coiling. We assessed the initial neurological conditions, complications and anatomic results. The follow-up results were evaluated with DSA and mRS.

Results

Stent deployment was successful in 104 of 108 procedures (96.3%). 11 complications (10.2%) occurred during procedures, including 5 events of aneurysm rupture, 3 events of thromboembolism. The rate of complication, rupture and thromboembolism was not statistically different between the ruptured and unruptured patients (P=0.452, P=0.369, P=1.000, respectively). The initial aneurysmal occlusion was Raymond scale (RS) 1 in 34 patients (31.5%), RS2 in 53 patients (49.1%), and RS3 in 21 patients (19.4%). 79 aneurysms were available for anatomic follow-up of 12–47 months, stable occlusion in 45 aneurysms (57.0%), progressive complete occlusion in 34 aneurysms (43.0%). 95 patients(88.0%) were available for a clinical follow-up of 12–52 months, 92 patients (96.8%) had favorable clinical outcomes (mRS ≤2), 3 patients (3.2%) had morbidity (mRS: 3–5). The morbidity was not statistically different between the ruptured and unruptured patients (P=1.000).

Conclusions

Stent-assisted coiling of very small wide-necked intracranial aneurysms may be effective and safe. Because of low risk of rupture in such aneurysms, the coiling of unruptured such aneurysms must be selective. The long-term efficacy and safety of coiling such aneurysms remains to be determined in larger prospective series.

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Keywords

Intracranial aneurysm, Stent, Coiling, Very small, Wide-necked

About this article
Title

Stent-assisted coiling of very small wide-necked intracranial aneurysms: Complications, anatomical results and clinical outcomes

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 50, No 6 (2016)

Pages

410-417

Page views

576

Article views/downloads

650

DOI

10.1016/j.pjnns.2016.07.004

Bibliographic record

Neurol Neurochir Pol 2016;50(6):410-417.

Keywords

Intracranial aneurysm
Stent
Coiling
Very small
Wide-necked

Authors

Wenjun Ji
Huibin Kang
Aihua Liu
Youxiang Li
Xin Feng
Zenghui Qian
Xiaolong Wen
Wenjuan Xu
Chuhan Jiang
Xinjian Yang
Zhongxue Wu

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