Stenting is improving and stabilizing anatomical results of coiled intracranial aneurysms

Neuroradiology. 2009 Jun;51(6):419-25. doi: 10.1007/s00234-009-0519-6. Epub 2009 Mar 26.


Introduction: Stent-assisted coiling (SAC) is an alternative to surgical clipping for the treatment of wide-necked intracranial aneurysms (IA). However, little information is available concerning the long-term results of this treatment. The aim of this study was to report the long-term clinical and anatomical findings in 32 patients with 34 wide-necked IA treated by SAC.

Methods: A retrospective review of our prospectively maintained database identified all patients followed up for wide-necked IA treated by SAC. The clinical charts, procedural data, and angiographic results were reviewed.

Results: Thirty-two patients with 34 IA were identified including 25 asymptomatic patients, four with cranial nerve palsies, two with a subarachnoid hemorrhage, and one with transient ischemic attacks. Mean aneurysm size was 10.2 mm (range 3.5 to 26 mm). Embolization was successful in all patients and no procedure-related neurological morbidity or mortality was observed. Immediate anatomical results included nine complete occlusions (26.5%), two neck remnants (6%), and 23 incomplete occlusions (67.5%). Mean imaging follow-up of 20 months showed 18 further thrombosis (53%) and 16 stable results (47%). Finally, 27 aneurysms were completely occluded (79%), three had a neck remnant (9%), and four were incompletely occluded (12%). Asymptomatic and nonsignificant in-stent stenosis occurred in seven patients (22%).

Conclusions: SAC is safe and effective for the treatment of wide-necked IA. Despite unsatisfying immediate aneurysm occlusion, the adjunctive effect of the stent is stabilizing or significantly improving long-term anatomical results.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Vessel Prosthesis*
  • Cerebral Angiography*
  • Embolization, Therapeutic / instrumentation*
  • Equipment Failure Analysis
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / surgery*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prosthesis Design
  • Retrospective Studies
  • Stents*
  • Treatment Outcome