open access

Vol 50, No 6 (2016)
Original research articles
Submitted: 2015-10-21
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Stent-assisted embolization of wide-neck anterior communicating artery aneurysms: Review of consecutive 34 cases

Damian Kocur, Miłosz Zbroszczyk, Nikodem Przybyłko, Mariusz Hofman, Tomasz Jamróz, Jan Baron, Piotr Bażowski, Stanisław Kwiek
DOI: 10.1016/j.pjnns.2016.07.008
·
Neurol Neurochir Pol 2016;50(6):425-431.

open access

Vol 50, No 6 (2016)
Original research articles
Submitted: 2015-10-21

Abstract

Objective

We report our experience with stent-assisted coiling of anterior communicating artery aneurysms with special consideration of angiographic and clinical outcomes, retreatment rate and periprocedural complications.

Materials and methods

The analysis included 34 consecutive ruptured and unruptured wide-neck aneurysms. The aneurysm size ranged from 2 to 18mm (mean 5.47). Clinical examinations with the use of modified Rankin Score and angiographic outcomes were evaluated initially post-embolization and at a minimum follow-up of 6 months.

Results

Initial post-treatment complete and near-complete aneurysm occlusion was achieved in 32 (94%) and 2 (6%) cases, respectively. Imaging follow-up, performed in 28 (82%) patients, showed no change in the degree of occlusion in 25 (89%) cases and coil compaction in 3 (11%) patients. Of these, one (3.6%) patient underwent a second coil embolization. The periprocedural severe complication rate was 2.9% (1/35) and was associated with prolonged attempt of retrieval of migrated coil resulting in anterior cerebral artery infarct with serious clinical consequences. In another 3 patients periprocedural adverse events without delayed clinical consequences were noticed. The clinical follow-up evaluation achieved in 33 (97%) patients showed no change in 30 (91%) cases, one patient (3%) with clinical improvement and two (6%) cases of neurological deterioration.

Conclusions

The use of stent is feasible and effective for coil embolization of wide-necked anterior communicating artery aneurysms. Although periprocedural complications resulting in severe morbidity are rare, they should be noted, since in terms of thromboembolic events some of them presumably have a potential to be avoidable.

Abstract

Objective

We report our experience with stent-assisted coiling of anterior communicating artery aneurysms with special consideration of angiographic and clinical outcomes, retreatment rate and periprocedural complications.

Materials and methods

The analysis included 34 consecutive ruptured and unruptured wide-neck aneurysms. The aneurysm size ranged from 2 to 18mm (mean 5.47). Clinical examinations with the use of modified Rankin Score and angiographic outcomes were evaluated initially post-embolization and at a minimum follow-up of 6 months.

Results

Initial post-treatment complete and near-complete aneurysm occlusion was achieved in 32 (94%) and 2 (6%) cases, respectively. Imaging follow-up, performed in 28 (82%) patients, showed no change in the degree of occlusion in 25 (89%) cases and coil compaction in 3 (11%) patients. Of these, one (3.6%) patient underwent a second coil embolization. The periprocedural severe complication rate was 2.9% (1/35) and was associated with prolonged attempt of retrieval of migrated coil resulting in anterior cerebral artery infarct with serious clinical consequences. In another 3 patients periprocedural adverse events without delayed clinical consequences were noticed. The clinical follow-up evaluation achieved in 33 (97%) patients showed no change in 30 (91%) cases, one patient (3%) with clinical improvement and two (6%) cases of neurological deterioration.

Conclusions

The use of stent is feasible and effective for coil embolization of wide-necked anterior communicating artery aneurysms. Although periprocedural complications resulting in severe morbidity are rare, they should be noted, since in terms of thromboembolic events some of them presumably have a potential to be avoidable.

Get Citation

Keywords

Anterior communicating artery aneurysm, Wide-neck aneurysm, Stent-assisted embolization

About this article
Title

Stent-assisted embolization of wide-neck anterior communicating artery aneurysms: Review of consecutive 34 cases

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 50, No 6 (2016)

Pages

425-431

DOI

10.1016/j.pjnns.2016.07.008

Bibliographic record

Neurol Neurochir Pol 2016;50(6):425-431.

Keywords

Anterior communicating artery aneurysm
Wide-neck aneurysm
Stent-assisted embolization

Authors

Damian Kocur
Miłosz Zbroszczyk
Nikodem Przybyłko
Mariusz Hofman
Tomasz Jamróz
Jan Baron
Piotr Bażowski
Stanisław Kwiek

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