Acta Neurochirurgica

, Volume 159, Issue 1, pp 93–100

Stent-assisted coiling embolization of tiny, wide-necked intracranial aneurysms

  • Yongtao Zheng
  • Yanbing Song
  • Dajun Liu
  • Yingjun Liu
  • Qiang Xu
  • Yanlong Tian
  • Bing Leng
Original Article - Vascular

DOI: 10.1007/s00701-016-3022-y

Cite this article as:
Zheng, Y., Song, Y., Liu, D. et al. Acta Neurochir (2017) 159: 93. doi:10.1007/s00701-016-3022-y
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Abstract

Background

Tiny, wide-necked intracranial aneurysms pose a significant therapeutic challenge for interventional neuroradiologists because of the small volume for microcatheterization and coil stabilization inside the aneurysm sac. We report our preliminary experience of stent-assisted coiling embolization of these aneurysms.

Methods

A total of 50 patients with 52 tiny, wide-necked aneurysms who were treated with stent-assisted coiling from January 2007 to December 2014 were reviewed retrospectively. Baseline characteristics, procedure-related complications, angiographic follow-up results and clinical outcomes were statistically analyzed.

Result

All aneurysms were successfully treated with the stent-assisted coiling technique, and at the end of the procedure, aneurysm occlusion was complete for 45 (86.5 %), near complete for 3 (5.8 %) and incomplete for 4 (7.7 %). Procedural complications (1 intraprocedural rupture, 2 coil migrations and 1 aneurysm re-rupture) occurred in 4 (8 %) of 50 patients, resulting in permanent morbidity in 1 (2 %) patient and death in 1 (2 %) patient. Follow-up imaging was available in 43 (84.3 %) aneurysms for 6–31 months (mean, 13 months). Complete occlusion was achieved in 40 (93 %) of 43 aneurysms on long-term follow-up. One aneurysm with complete occlusion and one with incomplete occlusion after the initial embolization developed a significant recurrence (4.7 %). Clinical follow-up was available for 43 (86 %) of 50 patients at a mean of 36.7 months (range 15–66 months). Of these 43 patients, 42 (97 %) made an excellent recovery achieving a GOS of 5. None of the patients died or experienced re-bleeding or ischemic cerebral vascular events during follow-up.

Conclusion

Stent-assisted coiling embolization is feasible and relatively safe for tiny, wide-necked intracranial aneurysms of carotid arteries. Furthermore, long-term follow-up angiography indicated stent-assisted coiling seems to be effective in preventing early recanalization.

Keyword

Stent-assisted coiling Tiny intracranial aneurysm Complication Recanalization 

Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Yongtao Zheng
    • 1
  • Yanbing Song
    • 1
  • Dajun Liu
    • 2
  • Yingjun Liu
    • 1
  • Qiang Xu
    • 3
  • Yanlong Tian
    • 1
  • Bing Leng
    • 1
  1. 1.Department of Neurosurgery, Huashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
  2. 2.Department of NeurosurgerySecond People HospitalTaizhouChina
  3. 3.Department of Radiology, Huashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina