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

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• 作者：Wenjun Ji^a ; ¹ ; ^{jwjdoctor@sina.com" class="auth_mail" title="E-mail the corresponding author} ; Huibin Kang^a ; ^b ; ¹ ; ^{kanghuibindoctor@163.com" class="auth_mail" title="E-mail the corresponding author} ; Aihua Liu^a ; ^{liuaihuadoctor@163.com" class="auth_mail" title="E-mail the corresponding author} ; Youxiang Li^a ; ^{liyouxiang_ttyy@126.com" class="auth_mail" title="E-mail the corresponding author} ; Xin Feng^a ; ^{627440730@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Zenghui Qian^a ; ^{370453167@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Xiaolong Wen^a ; ^{371357547@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Wenjuan Xu^a ; ^{841700194@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Chuhan Jiang^a ; ^{jiangchuhan_ttyy@126.com" class="auth_mail" title="E-mail the corresponding author} ; Xinjian Yang^a ; ^{1053157367@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Zhongxue Wu^a ; ^{wuzhongxue_yjs@126.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Intracranial aneurysm ; Stent ; Coiling ; Very small ; Wide-necked
• 刊名：Neurologia i Neurochirurgia Polska
• 出版年：2016
• 出版时间：November-December 2016
• 年：2016
• 卷：50
• 期：6
• 页码：410-417
• 全文大小：371 K

文摘

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

ec_2">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.

ec_3">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 (<em>Pem> = 0.452, <em>Pem> = 0.369, <em>Pem> = 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 &le;2), 3 patients (3.2%) had morbidity (mRS: 3–5). The morbidity was not statistically different between the ruptured and unruptured patients (<em>Pem> = 1.000).

ec_4">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.