Stent-assisted coiling of unruptured intracranial aneurysms: long-term follow-up in 164 patients with 183 aneurysms

J Neuroradiol. 2014 Dec;41(5):322-8. doi: 10.1016/j.neurad.2014.01.001. Epub 2014 Jan 23.


Purpose: Stent-assisted coiling (SAC) is increasingly used to treat complex unruptured intracranial aneurysms (UIA) including wide-necked and fusiform IA. However, few data are available over the long-term results of this technique. We report our 9-year-experience of SAC of UIA.

Methods: A retrospective review of our prospectively maintained database identified all patients treated by SAC for an UIA in 2 institutions. The clinical charts, procedural data and angiographic results were reviewed.

Results: Between 2004 and 2012, we identified 164 patients with 183 UIA. There were 115 women and 49 men with a mean age of 46 years. Embolization was successful in all patients. Procedural morbidity and mortality rates were 2.2% and 0% respectively. Immediate anatomical outcome included 54 complete occlusion (29.5%), 43 neck remnants (23.5%) and 86 incomplete occlusions (47%). Imaging follow-up was available in 137 patients (mean=26 months, range 3 to 99 months) and it showed 104 complete occlusions (75.9%), 23 neck remnants (16.8%) and 10 incomplete occlusions (7.3%). At follow-up, only 3 patients developed a significant intrastent stenosis, one of which was induced by radiosurgery. One of these patients had a symptomatic thrombo-embolic complication 3 years after stent placement.

Conclusion: SAC of complex UIA is effective and associated with low complication rates. Even if immediate anatomical results are relatively unsatisfying, mid- and long-term follow-up show a major improvement with a high rate of adequate occlusion that is stable over time. Moreover, the long-term clinical and angiographic tolerance of intracranial stents is excellent.

Keywords: Endovascular procedure; Intracranial aneurysm; Stent-assisted coiling.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured / diagnostic imaging
  • Aneurysm, Ruptured / mortality
  • Aneurysm, Ruptured / therapy
  • Belgium / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / mortality*
  • Intracranial Aneurysm / therapy*
  • Longitudinal Studies
  • Male
  • Mechanical Thrombolysis / instrumentation*
  • Mechanical Thrombolysis / methods
  • Mechanical Thrombolysis / mortality*
  • Middle Aged
  • Prevalence
  • Radiography
  • Retrospective Studies
  • Risk Factors
  • Stents / statistics & numerical data*
  • Survival Rate
  • Treatment Outcome