Y Chau1, L Mondot2, M Sachet2, J Gaudart3, D Fontaine4, M Lonjon4, J Sédat2. 1. University Teaching Hospital of Nice, Pasteur Hospital, Radiology Department, Neural Intervention Unit, France chau.y@chu-nice.fr. 2. University Teaching Hospital of Nice, Pasteur Hospital, Radiology Department, Neural Intervention Unit, France. 3. La Timone Hospital, Public Health and Medical Information Department, University Teaching Hospital of Marseilles, France. 4. University Teaching Hospital of Nice, Neurosurgery Department, France.
Abstract
BACKGROUND AND PURPOSE: Recent studies demonstrated the capacity of stents to modify cerebral vascular anatomy. This study evaluates arterial anatomy deformation after Leo stent placement according to the stenting site and the impact on the immediate postoperative and six-month degree of aneurysmal occlusion. MATERIALS AND METHODS: A total of 102 stents were placed against the neck of aneurysms situated in the anterior cerebral circulation. Aneurysms were classified into two groups: The first was called the distal group (n = 62) and comprised aneurysms situated in the middle cerebral and anterior communicating arteries and the second was called the proximal group (n = 40) and comprised aneurysms in other sites. The stented arterial segment was classified as deformed or non-deformed by blinded review and superimposition of anonymised films before and after stenting. The degree of occlusion was determined immediately postoperatively and at six months. RESULTS: Significantly, anatomical deformity was observed in the distal group compared to the proximal group (85% vs 28%). No significant difference was observed between the two groups in terms of postoperative degree of occlusion. At six months, a significant difference was observed between the two groups: three recurrences in the distal group vs 10 recurrences in the proximal group. Two (3%) recurrences were observed in the deformed group vs 11 (31%) recurrences in the non-deformed group. CONCLUSIONS: Arterial deformity induced by stenting is even more marked for distal aneurysms. The recurrence rate is smaller when the stent placement results in an arterial anatomical change. The percentage of recurrence is lower when anatomy was amended by stent implantation.
BACKGROUND AND PURPOSE: Recent studies demonstrated the capacity of stents to modify cerebral vascular anatomy. This study evaluates arterial anatomy deformation after Leo stent placement according to the stenting site and the impact on the immediate postoperative and six-month degree of aneurysmal occlusion. MATERIALS AND METHODS: A total of 102 stents were placed against the neck of aneurysms situated in the anterior cerebral circulation. Aneurysms were classified into two groups: The first was called the distal group (n = 62) and comprised aneurysms situated in the middle cerebral and anterior communicating arteries and the second was called the proximal group (n = 40) and comprised aneurysms in other sites. The stented arterial segment was classified as deformed or non-deformed by blinded review and superimposition of anonymised films before and after stenting. The degree of occlusion was determined immediately postoperatively and at six months. RESULTS: Significantly, anatomical deformity was observed in the distal group compared to the proximal group (85% vs 28%). No significant difference was observed between the two groups in terms of postoperative degree of occlusion. At six months, a significant difference was observed between the two groups: three recurrences in the distal group vs 10 recurrences in the proximal group. Two (3%) recurrences were observed in the deformed group vs 11 (31%) recurrences in the non-deformed group. CONCLUSIONS: Arterial deformity induced by stenting is even more marked for distal aneurysms. The recurrence rate is smaller when the stent placement results in an arterial anatomical change. The percentage of recurrence is lower when anatomy was amended by stent implantation.
Authors: Sophie Gallas; Anne Pasco; Jean-Philippe Cottier; Jean Gabrillargues; Jacques Drouineau; Christophe Cognard; Denis Herbreteau Journal: AJNR Am J Neuroradiol Date: 2005-08 Impact factor: 3.825
Authors: Young Dae Cho; Jong Young Lee; Jung Hwa Seo; Seung Jin Lee; Hyun-Seung Kang; Jeong Eun Kim; Young Je Son; Keun-Hwa Jung; O-Ki Kwon; Moon Hee Han Journal: Neurosurgery Date: 2012-12 Impact factor: 4.654
Authors: Yuichi Murayama; Yih Lin Nien; Gary Duckwiler; Y Pierre Gobin; Reza Jahan; John Frazee; Neil Martin; Fernando Viñuela Journal: J Neurosurg Date: 2003-05 Impact factor: 5.115
Authors: Adriana Campi; Najib Ramzi; Andrew J Molyneux; Paul E Summers; Richard S C Kerr; Mary Sneade; Julia A Yarnold; Joan Rischmiller; James V Byrne Journal: Stroke Date: 2007-03-29 Impact factor: 7.914