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    Stent-assisted coil embolization of aneurysms with small parent vessels: safety and efficacy analysis

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    Authors
    Kuhn, Anna L.
    Hou, Samuel Y.
    Puri, Ajit S.
    Silva, Christine F.
    Gounis, Matthew J.
    Wakhloo, Ajay K.
    UMass Chan Affiliations
    Department of Radiology
    Document Type
    Journal Article
    Publication Date
    2016-06-01
    Keywords
    Nervous System Diseases
    Neurology
    Radiology
    Surgery
    
    Metadata
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    Link to Full Text
    http://dx.doi.org/10.1136/neurintsurg-2015-011774
    Abstract
    BACKGROUND: Stent-assisted coil embolization (SACE) is a viable therapeutic approach for wide-neck intracranial aneurysms. However, it can be technically challenging in small cerebral vessels ( < /=2 mm). OBJECTIVE: To present our experience with stents approved for SACE in aneurysms with small parent arteries. METHODS: All patients who underwent stent-assisted aneurysm treatment with either a Neuroform or an Enterprise stent device at our institution between June 2006 and October 2012 were identified. Additionally, we evaluated each patient's vascular risk factors, aneurysm characteristics (ruptured vs non-ruptured, incidental finding, recanalized) and follow-up angiography data. RESULTS: A total of 41 patients with 44 aneurysms met our criteria, including 31 women and 10 men. Most of the aneurysms were located in the anterior circulation (75%). Stent placement in vessels 1.2-2 mm in diameter was successful in 93.2%. Thromboembolic complications occurred in 6 cases and vessel straightening was seen in 1 case only. Initial nearly complete to complete aneurysm obliteration was achieved in 88.6%. Six-month follow-up angiography showed coil compaction in three cases, one asymptomatic in-stent stenosis and stent occlusion. Twelve to 20-months' follow-up showed stable coil compaction in two patients compared with previous follow-up, and aneurysm recanalization in two patients. Twenty-four to 36-months' follow-up showed further coil compaction in one of these patients and aneurysm recanalization in a previous case of stable coil compaction on mid-term follow-up. CONCLUSIONS: Our results suggest that SACE of aneurysms with small parent vessels is feasible in selected cases and shows good long-term patency rates of parent arteries.
    Source
    J Neurointerv Surg. 2016 Jun;8(6):581-5. doi: 10.1136/neurintsurg-2015-011774. Epub 2015 Jun 3. Link to article on publisher's site
    DOI
    10.1136/neurintsurg-2015-011774
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/48059
    PubMed ID
    26041097
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1136/neurintsurg-2015-011774
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