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 Ji, Huibin Kang, Aihua Liu, Youxiang Li, Xin Feng, Zenghui Qian, Xiaolong Wen, Wenjuan Xu, Chuhan Jiang, Xinjian Yang, Zhongxue Wu
DOI: 10.1016/j.pjnns.2016.07.004
·
Neurol Neurochir Pol 2016;50(6):410-417.

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

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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