Benjamin Mine1, Ali Aljishi2, Jean-Bernard D'Harcour2, Denis Brisbois2, Laurent Collignon2, Boris Lubicz2. 1. Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, 808, route de Lennik, 1070 Brussels, Belgium. Electronic address: benjamin_mine@me.com. 2. Department of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, 808, route de Lennik, 1070 Brussels, Belgium.
Abstract
PURPOSE: Stent-assisted coiling (SAC) is increasingly used to treat complex unruptured intracranial aneurysms (UIA) including wide-necked and fusiform IA. However, few data are available over the long-term results of this technique. We report our 9-year-experience of SAC of UIA. METHODS: A retrospective review of our prospectively maintained database identified all patients treated by SAC for an UIA in 2 institutions. The clinical charts, procedural data and angiographic results were reviewed. RESULTS: Between 2004 and 2012, we identified 164 patients with 183 UIA. There were 115 women and 49 men with a mean age of 46 years. Embolization was successful in all patients. Procedural morbidity and mortality rates were 2.2% and 0% respectively. Immediate anatomical outcome included 54 complete occlusion (29.5%), 43 neck remnants (23.5%) and 86 incomplete occlusions (47%). Imaging follow-up was available in 137 patients (mean=26 months, range 3 to 99 months) and it showed 104 complete occlusions (75.9%), 23 neck remnants (16.8%) and 10 incomplete occlusions (7.3%). At follow-up, only 3 patients developed a significant intrastent stenosis, one of which was induced by radiosurgery. One of these patients had a symptomatic thrombo-embolic complication 3 years after stent placement. CONCLUSION: SAC of complex UIA is effective and associated with low complication rates. Even if immediate anatomical results are relatively unsatisfying, mid- and long-term follow-up show a major improvement with a high rate of adequate occlusion that is stable over time. Moreover, the long-term clinical and angiographic tolerance of intracranial stents is excellent.
PURPOSE: Stent-assisted coiling (SAC) is increasingly used to treat complex unruptured intracranial aneurysms (UIA) including wide-necked and fusiform IA. However, few data are available over the long-term results of this technique. We report our 9-year-experience of SAC of UIA. METHODS: A retrospective review of our prospectively maintained database identified all patients treated by SAC for an UIA in 2 institutions. The clinical charts, procedural data and angiographic results were reviewed. RESULTS: Between 2004 and 2012, we identified 164 patients with 183 UIA. There were 115 women and 49 men with a mean age of 46 years. Embolization was successful in all patients. Procedural morbidity and mortality rates were 2.2% and 0% respectively. Immediate anatomical outcome included 54 complete occlusion (29.5%), 43 neck remnants (23.5%) and 86 incomplete occlusions (47%). Imaging follow-up was available in 137 patients (mean=26 months, range 3 to 99 months) and it showed 104 complete occlusions (75.9%), 23 neck remnants (16.8%) and 10 incomplete occlusions (7.3%). At follow-up, only 3 patients developed a significant intrastent stenosis, one of which was induced by radiosurgery. One of these patients had a symptomatic thrombo-embolic complication 3 years after stent placement. CONCLUSION: SAC of complex UIA is effective and associated with low complication rates. Even if immediate anatomical results are relatively unsatisfying, mid- and long-term follow-up show a major improvement with a high rate of adequate occlusion that is stable over time. Moreover, the long-term clinical and angiographic tolerance of intracranial stents is excellent.
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