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NEUROFORM STENT-ASSISTED EMBOLIZATION OF INCIDENTAL ANTERIOR COMMUNICATING ARTERY ANEURYSMS: LONG-TERM CLINICAL AND ANGIOGRAPHIC FOLLOW-UP.
MedLine Citation:
PMID:  21311379     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Anterior communicating artery aneurysms (Acomms) are one of the most common intracranial aneurysms. Treatments include neurosurgical clipping or endovascular embolization. OBJECTIVE:: To retrospectively examine the long-term results of Neuroform stent-assisted coil embolization of incidental Acomms, with a focus on stent-associated stenosis, long-term angiographic aneurysm occlusion outcome, delayed stent-related thromboembolus, subsequent subarachnoid hemorrhage from the treated aneurysm, and procedural complications. METHODS:: Between January 7, 2003 and June 16, 2009, 44 Neuroform stents were placed as an adjunct to embolization of Acomms. Patient charts were reviewed retrospectively. Angiographic follow-up of at least 3 months (up to 6.5 years, mean 65 weeks) was available in 33 patients. Aneurysm occlusion success was determined using the Raymond classification for aneurysm remnants. RESULTS:: Referencing the last angiogram in the follow-up course, complete occlusion, dog-ear residual, residual neck, and residual aneurysm was found in 24, 2, 3, and 4 patients, respectively. Stenosis (45% and asymptomatic) of the arteries where the stent had been placed was found in one patient. One patient had delayed transient ischemic attack after dual antiplatelet therapy was stopped prematurely. Retreatment based on the presence of residual aneurysm was performed or recommended in two patients. In two patients with residual or recurrent aneurysm filling, their age or clinical condition did not warrant retreatment. CONCLUSION:: Neuroform stent-assisted embolization gives long-term control of Acomms with a low incidence of aneurysm growth after treatment. The need for retreatment is uncommon, and safe if performed. Subsequent bleeding from treated aneurysms was not observed in this study.
Authors:
Ahmed Raslan; Murat Oztaskin; Eric Thompson; Aclan Dogan; Bryan Petersen; Gary Nesbit; David S Lee; Stanley L Barnwell
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-09
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Neurological Surgery, 2Dotter Institute of Interventional Therapy, 3Division of Cardiovascular Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR.
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