Coil embolization using the self-expandable closed-cell stent for intracranial saccular aneurysm: a single-center experience of 289 consecutive aneurysms

Clin Radiol. 2013 Mar;68(3):256-63. doi: 10.1016/j.crad.2012.07.017. Epub 2012 Sep 25.

Abstract

Aim: To present the clinical and radiological follow-up results of coil embolization using the Enterprise stent for intracranial saccular aneurysms.

Materials and methods: The clinical and morphological outcomes of 261 consecutive patients with a total of 289 aneurysms that were treated with a stent-protected coiling technique using the Enterprise stent from June 2008 to August 2011 were assessed.

Results: Stents were delivered before first coil insertion in 162 aneurysms (56.1%), during coiling in 68 (23.5%), and after completion of coil insertion in 59 (20.4%). Procedure-related complications occurred in 36 patients (13.8%), and four (1.5%) suffered permanent neurological sequelae. Successful occlusion after coil embolization was achieved in 205 aneurysms (70.9%) and subtotal occlusion was achieved in 84. During the mean follow-up of 12.4 (±5.8) months, follow-up imaging of 229 aneurysms (79.2%) documented stable occlusion in 183 (79.9%) of the lesions, minor recanalization in 17 (7.4%), and major recanalization in 29 (12.7%). Follow-up angiography of 110 aneurysms (38.1%) demonstrated in-stent stenosis in 14 (12.7%) and stent migration in five (4.5%). Eleven patients (4.2%) suffered late delayed infarction during the follow-up period, which was related to cessation or modification of anti-platelet medication.

Conclusion: The stent-protection technique using the Enterprise stent is useful and effective for coil embolization of wide-necked aneurysms due to easy navigation and precise placement. However, the possibility of procedure-related complications, in-stent stenosis, and delayed cerebral infarction should be noted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cerebral Angiography
  • Chi-Square Distribution
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Postoperative Complications / diagnostic imaging
  • Stents*
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors