Journal article
Closed-Cell Stent for Coil Embolization of Intracranial Aneurysms: Clinical and Angiographic Results
American journal of neuroradiology : AJNR, Vol.33(9), pp.1651-1656
2012
DOI: 10.3174/ajnr.A3034
PMID: 22492570
Abstract
Background and purpose: Recanalization is observed in 20-40% of endovascularly treated intracranial aneurysms. To further reduce the recanalization and expand endovascular treatment, we evaluated the safety and efficacy of closed-cell SACE.
Materials and methods: Between 2007 and 2010, 147 consecutive patients (110 women; mean age, 54 years) presenting at 2 centers with 161 wide-neck ruptured and unruptured aneurysms were treated by using SACE. Inclusion criteria were wide-neck aneurysms (>4 mm or a dome/neck ratio ≤ 2). Clinical outcomes were assessed by the mRS score at baseline, discharge, and follow-up. Aneurysm occlusion was assessed on angiograms by using the RS immediately after SACE and at follow-up.
Results: Eighteen aneurysms (11%) were treated following rupture. Procedure-related mortality and permanent neurologic deficits occurred in 2 (1.4%) and 5 patients (3.4%), respectively. In total, 7 patients (4.8%) died, including 2 with reruptures. Of the 140 surviving patients, 113 (80.7%) patients with 120 aneurysms were available for follow-up neurologic examination at a mean of 11.8 months. An increase in mRS score from admission to follow-up by 1, 2, or 3 points was seen in 7 (6.9%), 1 (1%), and 2 (2%) patients, respectively. Follow-up angiography was performed in 120 aneurysms at a mean of 11.9 months. Recanalization occurred in 12 aneurysms (10%), requiring retreatment in 7 (5.8%). Moderate in-stent stenosis was seen in 1 (0.8%), which remained asymptomatic.
Conclusions: This series adds to the evidence demonstrating the safety and effectiveness of SACE in the treatment of intracranial aneurysms. However, SACE of ruptured aneurysms and premature termination of antiplatelet treatment are associated with increased morbidity and mortality.
Details
- Title: Subtitle
- Closed-Cell Stent for Coil Embolization of Intracranial Aneurysms: Clinical and Angiographic Results
- Creators
- A. K WAKHLOO - Department of Radiology New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, United StatesI LINFANTE - Baptist Cardiac and Vascular Institute, Miami Florida, United StatesC. F SILVA - Department of Radiology New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, United StatesE. A SAMANIEGO - Baptist Cardiac and Vascular Institute, Miami Florida, United StatesG DABUS - Baptist Cardiac and Vascular Institute, Miami Florida, United StatesV ETEZADI - Department of Radiology University of Pennsylvania, Philadelphia, Pennsylvania, United StatesG SPILBERG - Department of Radiology New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, United StatesM. J GOUNIS - Department of Radiology New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, United States
- Resource Type
- Journal article
- Publication Details
- American journal of neuroradiology : AJNR, Vol.33(9), pp.1651-1656
- DOI
- 10.3174/ajnr.A3034
- PMID
- 22492570
- NLM abbreviation
- AJNR Am J Neuroradiol
- ISSN
- 0195-6108
- eISSN
- 1936-959X
- Publisher
- American Society of Neuroradiology; Oak Brook, IL
- Language
- English
- Date published
- 2012
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984014017502771
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