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Neuroform stent-assisted treatment of intracranial aneurysms: long-term follow-up study of aneurysm recurrence and in-stent stenosis rates

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Our purpose was to analyze the long-term evolution of wide neck cerebral aneurysms treated with stent assistance.

Methods

Data of consecutive patients treated with the Neuroform stent over 9 years were retrospectively analyzed with emphasis on periprocedural complications, aneurysm occlusion grade evolution, and in-stent stenosis rates.

Results

Altogether, 113 patients with 117 unruptured and ruptured aneurysms were subject of analysis. Mean aneurysm size was 9.4 mm, and mean neck size was 4.7 mm. Procedural thromboembolic and hemorrhagic complications affected eight (6.8 %) and four cases (3.4 %), respectively. Immediate complete occlusion and occlusion with residual neck was achieved in 85 % of cases, which at the first follow-up of 6 months, changed to 77 and 76 % at 36 months. Aneurysms ≥10 mm showed a higher tendency of recurrence. During the overall follow-up time ranging from 1 to 9 years, an in-stent stenosis of ≥50 % was observed only in three cases, all of them being asymptomatic.

Conclusions

Stent-assisted coiling of wide neck aneurysms provided stable occlusion over the long-term follow-up, with very low and silent in-stent stenosis rates. Some incompletely occluded aneurysms showed a tendency of progressive occlusion; however, this was counterbalanced by the regrowth of others.

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Abbreviations

AComA:

Anterior communicating artery

ACA:

Anterior cerebral artery

DSA:

Digital subtraction angiography

DWI:

Diffusion-weighted imaging

ICA:

Internal carotid artery

MCA:

Middle cerebral artery

MR:

Magnetic resonance

MRA:

MR angiography

SAC:

Stent-assisted coiling

PCA:

Posterior cerebral artery

TOF:

Time of flight

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Conflict of interest

The Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen, Germany, acknowledges financial support for furthering research and education in Interventional Neuroradiology through an institutional grant support from Boston Scientific/Stryker.

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Authors and Affiliations

  1. Department of Neuroradiology, Swiss Neuro Institute, Hirslanden Clinic, Zurich, Switzerland

    Zsolt Kulcsár & Isabel Wanke

  2. Center of Applied Biotechnology and Molecular Medicine, University of Zurich, Zurich, Switzerland

    Zsolt Kulcsár

  3. Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen, Hufelandstrasse 55, 45122, Essen, Germany

    Sophia L. Göricke, Marc Schlamann, Susanne Ladd, Michael Forsting & Isabel Wanke

  4. Department of Neuroradiology, Innsbruck Medical University, Innsbruck, Austria

    Elke R. Gizewski

  5. Department of Neurosurgery, University Hospital of Essen, Essen, Germany

    Ulrich Sure & I. Erol Sandalcioglu

  6. Department of Neurology, University Hospital of Essen, Essen, Germany

    Petra Mummel & Oliver Kastrup

Authors
  1. Zsolt Kulcsár
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  2. Sophia L. Göricke
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  3. Elke R. Gizewski
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  4. Marc Schlamann
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  5. Ulrich Sure
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  6. I. Erol Sandalcioglu
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  7. Susanne Ladd
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  8. Petra Mummel
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  9. Oliver Kastrup
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  10. Michael Forsting
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  11. Isabel Wanke
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Corresponding author

Correspondence to Isabel Wanke.

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Kulcsár, Z., Göricke, S.L., Gizewski, E.R. et al. Neuroform stent-assisted treatment of intracranial aneurysms: long-term follow-up study of aneurysm recurrence and in-stent stenosis rates. Neuroradiology 55, 459–465 (2013). https://doi.org/10.1007/s00234-013-1143-z

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  • DOI: https://doi.org/10.1007/s00234-013-1143-z

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