Endovascular Treatment of Intracranial Aneurysms With Parent Vessel Reconstruction Using Balloon and Self Expandable Stents

Acta Neurochir (Wien). 2006 Jul;148(7):711-23; discussion 723. doi: 10.1007/s00701-006-0785-6. Epub 2006 May 17.

Abstract

Background and purpose: To assess the feasibility and results of parent vessel stent reconstruction with balloon expandable and self-expandable stents in the treatment of intracranial aneurysms.

Methods: In a total of 18 aneurysms balloon expandable (group A) and self expandable (group B) stents were used in 9 cases each. Stent implantation alone was used in 3 cases, and additional coil packing in the other 15.

Results: Stents were successfully deployed in 8 out of 9 in group A and in 9 out of 9 cases in group B. Nearly complete occlusion was achieved in all but one case. At 3 or 6 months stable occlusion was found in 4 group A and 2 group B patients, progressive thrombosis in 3 cases in both groups, and recanalisation in 1 case in group B. Late follow up at 1-4 years demonstrated one progressive thrombosis one recanalisation and 1 stable occlusion in 3 group A, and 2 stable occlusions in 2 group B. patients. Complications included one aneurysm perforation in group A, one in-stent thrombosis and a distal arterial perforation in group B and one groin hematoma in both groups.

Conclusion: Stent reconstruction of intracranial arteries harbouring aneurysms is feasible and may result in aneurysm thrombosis without coil packing in some cases. Self expanding stents seem to provide a higher rate of success. Aggressive antiplatelet treatment increases the risk of hemorrhagic complications.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Balloon Occlusion / methods*
  • Balloon Occlusion / standards
  • Balloon Occlusion / statistics & numerical data
  • Cerebral Angiography
  • Cerebral Arteries / diagnostic imaging
  • Cerebral Arteries / pathology
  • Cerebral Arteries / surgery*
  • Feasibility Studies
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy*
  • Intracranial Thrombosis / etiology
  • Intracranial Thrombosis / physiopathology
  • Intracranial Thrombosis / prevention & control
  • Intraoperative Complications / etiology
  • Intraoperative Complications / physiopathology
  • Male
  • Middle Aged
  • Reconstructive Surgical Procedures / instrumentation*
  • Reconstructive Surgical Procedures / methods
  • Stents* / statistics & numerical data
  • Treatment Outcome
  • Vascular Surgical Procedures / instrumentation*
  • Vascular Surgical Procedures / methods