| In-stent thrombosis and stenosis after neck-remodeling device-assisted coil embolization of intracranial aneurysms. | |
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MedLine Citation:
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PMID: 21107183 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Intrinsic thrombosis and stenosis are complications associated with the use of neck-remodeling devices in the treatment of intracranial aneurysms. OBJECTIVE: To examine the technical and anatomic factors that predict short- and long-term stent patency. METHODS: We undertook a retrospective review of 161 patients who underwent coil embolization of 168 ruptured and unruptured aneurysms assisted by the use of a neck-remodeling device. One hundred twenty-seven patients had catheter-based angiographic follow-up to evaluate 133 stent-coil constructs (mean, 15.4 months; median, 12.7 months). The technique of microcatheter jailing was used in a majority of patients; nonstandard stent configurations were also used. RESULTS: Clinical follow-up for all patients who had catheter-based angiograms demonstrated that among 133 stent constructs, a total of 9 (6.8%) had an in-stent event: 6 acute or subacute thrombosis (4.5%) and 3 delayed stenosis or occlusion (2.3%). Seven of these constructs were associated with a symptomatic event (5.3%). A significantly higher rate of in-stent events was seen with the use of constructs to treat anterior communicating artery aneurysms. When all patients are considered, including those who did not receive catheter-based follow-up imaging, 2 of 168 procedures (1.2%) resulted in the death of a patient, and procedural morbidity was 14.9%. CONCLUSION: From these results and those in the published literature, in-stent complication rates are low in carefully selected patients. The use of dual antiplatelet therapy, sensitivity assays, and glycoprotein IIb/IIIa inhibitors may decrease the rate of acute and chronic in-stent complications. |
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Authors:
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Hilal Kanaan; Brian Jankowitz; Aitziber Aleu; Dean Kostov; Ridwan Lin; Kimberly Lee; Narendra Panipitiya; Yakov Gologorsky; Emir Sandhu; Lauren Rissman; Elizabeth Crago; Yue-Fang Chang; Seong-Rim Kim; Tudor Jovin; Michael Horowitz |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 67 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 1523-32; discussion 1532-3 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15206, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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