Enterprise stent-assisted coiling for wide-necked intracranial aneurysms during ultra-early (48hours) subarachnoid hemorrhage: a single-center experience in 59 consecutive patients

J Neuroradiol. 2015 Oct;42(5):298-303. doi: 10.1016/j.neurad.2014.11.005. Epub 2015 Feb 10.

Abstract

Background and objective: Accumulated experience and improvement of stents dedicated to intracranial use have significantly widened the applicability of stent-assisted coiling (SAC) to ruptured wide-necked aneurysms. This retrospective study was designed to evaluate the safety and efficacy of SAC using the Enterprise stent for ruptured wide-necked intracranial aneurysms during ultra-early subarachnoid hemorrhage.

Method: We reviewed data from 59 consecutive patients with ruptured wide-necked aneurysms who had SAC using the Enterprise stent performed within 48hours of onset. Data collected and analyzed included: patient demographics; morphologic features of the aneurysm; treatment results and follow-up results. Clinical outcomes were evaluated by modified Rankin Scale (mRS).

Results: In all 59 cases, SAC using the Enterprise stent was performed successfully, with no significant technical difficulties. Initial angiographic results were: complete occlusion in 38 cases; near occlusion in 17; and partial occlusion in four. Angiographic follow-up of 48 patients showed that 46 (95.8%) remained stable or improved, without regrowth, while regrowth was imaged in two patients. Medium-term clinical follow-up of 54 patients (mean, 26.9months) showed that 88.9% had a good outcome (mRS: 0 in 34; 1 in eight; and 2 in six), and 11.1% poor outcomes (mRS: 3 in four; and 4 in two).

Conclusion: Enterprise SAC is a safe and viable option for treatment of ruptured wide-necked aneurysms within 48hours of ictus.

Keywords: Aneurysm; Enterprise; Outcome; Rupture; Stent-assisted coiling; Subarachnoid hemorrhage; Wide-necked.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Vessel Prosthesis
  • Equipment Design
  • Equipment Failure Analysis
  • Female
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / therapy*
  • Male
  • Mechanical Thrombolysis / instrumentation*
  • Mechanical Thrombolysis / methods
  • Middle Aged
  • Retrospective Studies
  • Stents*
  • Subarachnoid Hemorrhage / diagnostic imaging*
  • Subarachnoid Hemorrhage / etiology
  • Subarachnoid Hemorrhage / prevention & control*
  • Treatment Outcome