Stent-assisted coiling of intracranial aneurysms using LEO stents: long-term follow-up in 153 patients

Neuroradiology. 2018 Feb;60(2):211-219. doi: 10.1007/s00234-017-1965-1. Epub 2017 Dec 23.

Abstract

Purpose: Coiling associated with placement of a self-expandable intracranial stent has improved the treatment of intracranial wide-necked aneurysms. Little is known, however, about the durability of this treatment. The purpose of this report is to present our experience with the LEO stent and to evaluate the complications, effectiveness, and long-term results of this technique.

Methods: We analyzed the records of 155 intracranial unruptured aneurysms that were treated by stent-assisted coiling with a LEO stent between 2008 and 2012. Procedural, early post-procedural, and delayed complications were recorded. Clinical and angiographic follow-up of patients was conducted over a period of at least 36 months.

Results: No procedural mortality was observed. One-month morbidity was observed in 14 out of 153 patients (9,15%). One hundred thirty-eight patients (with 140 aneurysms) had clinical and angiographic follow-up for more than 36 months. No aneurysm rupture was observed during follow-up. Four patients presented an intra-stent stenosis at 8 months, and 6 patients who had an early recurrence were retreated. Final results showed 85% complete occlusion, 13% neck remnants, and 2% stable incomplete occlusion.

Conclusion: Stent-assisted coiling with the LEO stent is a safe and effective treatment for unruptured intracranial aneurysms. The long-term clinical outcomes with the LEO stent are excellent with a high rate of complete occlusion that is stable over time.

Keywords: Clinical outcome; Endovascular treatment; Intracranial aneurysm; LEO stent; Stent-assisted coiling.

MeSH terms

  • Adult
  • Aged
  • Angiography, Digital Subtraction
  • Cerebral Angiography
  • Combined Modality Therapy
  • Embolization, Therapeutic / instrumentation*
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Recurrence
  • Retrospective Studies
  • Stents*
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors