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Selective Temporary Stent-Assisted Coil Embolization for Intracranial Wide-Necked Small Aneurysms Using Solitaire AB Retrievable Stent

Journal of Korean Neurosurgical Society 2019년 62권 1호 p.27 ~ 34
Heo Han-Yong, 안재근, Ji Cheol, 윤원기,
소속 상세정보
 ( Heo Han-Yong ) - Catholic University College of Medicine St. Paul’s Hospital Department of Neurosurgery
안재근 ( Ahn Jae-Guen ) - Catholic University College of Medicine St. Paul’s Hospital Department of Neurosurgery
 ( Ji Cheol ) - Catholic University College of Medicine St. Paul’s Hospital Department of Neurosurgery
윤원기 ( Yoon Won-Ki ) - Korea University College of Medicine Korea University Guro Hospital Department of Neurosurgery

Abstract


Objective: Stent-assisted coil embolization of intracranial wide-necked aneurysm requires long-term postoperative antiplatelet therapy to prevent in-stent thrombosis. This study aimed to demonstrate results of temporary stent placement for coiling wide necked small intracranial aneurysms, which eliminated need for antiplatelet agents, and to discuss its feasibility and safety.

Methods: Data of 156 patients who underwent stent-assisted coil embolization between 2011 and 2014 were retrospectively analyzed. Thirteen cases of temporary stent-assisted coil embolization were included, and their clinical and radiological results were evaluated.

Results: The aneurysms treated were all unruptured except one case. All of them had wide neck with mean dome-to-neck ratio of 0.96 and were small-sized aneurysms with mean maximal diameter of 4.2 mm. There was no technical failure in retrieval of stent after completion of embolization of the target aneurysm. Immediate angiography revealed 11 complete and two partial embolization (one residual neck and one residual aneurysm). Two cases encountered thrombosis complication, and they were managed without neurological sequelae. The mean follow-up period was 43 months, angiographic follow-up revealed two cases with minor recurrence, and clinical outcome was good with modified Rankin scale score of 0.

Conclusion: Temporary stent-assisted coil embolization of small wide-necked intracranial aneurysm using fully retrievable stent appears safe and effective. Further application and evaluation of this technique in more cases with larger size aneurysm is warranted.

키워드

Coil; Intracranial aneurysm; Stents

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