| Thromboembolic Complications After Neuroform™ Stent Assisted Treatment of Cerebral Aneurysms: The Duke Cerebrovascular Center Experience in 235 Patients with 274 Stents. | |
| | |
MedLine Citation:
|
PMID: 21499154 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND:: The Neuroform™ Stent has facilitated the endovascular treatment of wide-necked cerebral aneurysms. It is unknown which factors pose risks of thromboembolic events following stent placement. Objective: This series is the largest single-center study reporting on incidence of and factors influencing thromboembolic complications following Neuroform™ stent placement. METHODS:: 235 patients were treated with 274 Neuroform™ stents. Thromboembolic event rate was determined by imaging or clinical evidence of cerebrovascular accident within 90 days of stent placement; for patients with incomplete follow-up through chart review, telephone interviews were conducted. Analyses were performed to investigate patient factors that may be associated with stroke. RESULTS:: MOST ANEURYSMS WERE UNRUPTURED; 30 PATIENTS (12.8%) PRESENTED WITH ACUTE SUBARACHNOID HEMORRHAGE. 12 PATIENTS OF THE 224 WITH FOLLOW-UP (5.4 %, 95% CI 2.4-8.3%) DEMONSTRATED IMAGING OR CLINICAL EVIDENCE OF NEW THROMBOEMBOLIC EVENT WITHIN 90 DAYS OF STENT PLACEMENT. THERE WAS A 3.1% THROMBOEMBOLIC RATE FOR NON-RUPTURED ANEURYSMS AND A 20% RATE IN PATIENTS WITH SUBARACHNOID BLEED. HEMORRHAGE WAS SIGNIFICANTLY ASSOCIATED WITH HAVING A THROMBOEMBOLIC EVENT (P=0.002). THERE WAS A TREND TOWARD INCREASED THROMBOEMBOLIC EVENT RATE FOR PATIENTS WITH HYPERTENSION (P=0.07). LARGER STENT CALIBER WAS SIGNIFICANTLY ASSOCIATED WITH DECREASED THROMBOEMBOLIC EVENT RATE (P=0.032). CONCLUSIONS:: Our results suggest the thromboembolic event rate associated with Neuroform™ stent use is low in unruptured aneurysms. In ruptured aneurysms, complication rate is high, possibly partly related to restricted use of anti-platelet therapy. Stent size and hypertension may be associated with risk of stroke, but additional studies are needed to confirm their significance. |
| | |
Authors:
|
Mark L Lessne; Pratish Shah; Michael J Alexander; Huiman X Barnhart; Ciaran Powers; Kiarash Golshani; Andrew Ferrell; David Enterline; Ali Zomorodi; Tony Smith; Gavin W Britz |
Related Documents
:
|
8614924 - Evaluation of intracranial and extracranial carotid steno-occlusive diseases in taiwan ... 6188804 - The 5-hydroxytryptamine antagonist ketanserin inhibits the vasoconstrictor activity of ... 12187014 - Effects of the ultrasound contrast-enhancing agent levovist on the detection of intracr... 8293164 - Interventional neuroradiology. 9017484 - Delayed cardiac tamponade in a patient with penetrating chest trauma. 3415444 - Sudden death due to left coronary artery occlusion in infective endocarditis. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-4-14 |
Journal Detail:
|
Title: Neurosurgery Volume: - ISSN: 1524-4040 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
|
Created Date: 2011-4-18 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
1 Department of Radiology, Division of Neurointerventional Radiology, Duke University Medical Center, Durham, NC 27710, USA, 2 Department of Surgery, Division of Neurosurgery, Duke University Medical Center, Durham, NC 27710, USA, 3 Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA, 4 Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA, Financial and Material Support: None. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Early cease of intraaneurysmal contrast opacification during coil embolization in ruptured aneurysms...
Next Document: Incidence of Seizures or Epilepsy after Clipping versus Coiling of Ruptured and Unruptured Cerebral ...