Clinical research of aneurysms embolized with coils associated with self-expanding stents

GAO Tian; LI Dongmei; ZHANG Shiyong; LIU Qi; and MAO Gengsheng

PDF(510 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2012, Vol. 23 ›› Issue (4) : 318-320.

北京，武警总医院神经外科

Author information +

History +

Abstract

Objective To study the clinical value of treating intracranial aneurysms by embolization with coils associated with self-expanding stents. MehtodsA total of 44 patients aged 41 to 76（mean 51 years old）, including 20 male patients and 24 female patients, were recruited. In this study, All the aneurysms were treated by embolization with coils associated with self-expanding stents used specially for intracranial lesion. The stents were detached through microcatheters to make them cover the necks of aneurysms and coils were delivered to the lumens of aneurysms through other microcatheters. Results38 aneurysms reached complete occlusion and 6 aneurysms reached incomplete occlusion. There was no intra-stent thrombosis in any case and all the patients were evaluated as having benefited a lot when discharged. 36 patients were followed up for 3-6 months and all of them underwent cerebral vascular angiography. No recanalization was found and the parent arteries were clear in 35 aneurysms, 1 aneurysm was found residual in the neck, and no recurrence was found in any case. ConclusionsTreating intracranial aneurysms by embolization with coils associated with self-expanding stents can achieve good outcomes.

Key words

intracranial aneurysm / stent / microcatheter

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

GAO Tian, LI Dongmei, ZHANG Shiyong, LIU Qi, and MAO Gengsheng. Clinical research of aneurysms embolized with coils associated with self-expanding stents[J]. Medical Journal of the Chinese People Armed Police Forces. 2012, 23(4): 318-320

References

［1］〖JP2〗Phillips L H, Whisnant J P, O’Fallon W M,et al. The unchanging pattern of subarachnoid hemorrhage in a community［J］.Neurology, 1980, 30(10): 1034-1040.

［2］Malisch T W, Guglielmi G, Vinuela F,et al. Intracranial aneurysms treated with the Guglielmi detachable coil: midterm clinical results in a consecutive of 100 patients ［J］. J Neurosurg, 1997, 87(2): 176-183.

［3］Vinuela F, Duckwiler G, Mawad M. Guglielmi detachable coil embolization of acute intracranial aneurysm: perioperative anatomical and clinical outcome in 403 patients ［J］. J Neurosurg,1997, 86(3): 475-482.

［4］李茂林，王祝峰，刘西梅.颅内动脉瘤误诊4例［J］.武警医学，2007,18（2）：130-131.

［5］Lindsay K W. The impact of the International Subarachnoid Aneurysm Treatment Trial (ISAT) on neurosurgical practice［J］. Acta Neurochir, 2003, 145: 97-99.

［6］Pelz D M. Advances in interventional neuroradiology［J］. Stroke, 2003, 34: 357-358.

［7］Isoda H, Inagawa S, Takeda H.Preliminary study of tagged MR image velocimetry in a replica of an intracranial aneurysm［J］. AJNR Am J Neuroradiol，2003,24(4):604-607.

［8］Jou L D, Quick C M, Young W L. Computational approach to quantifying hemodynamic forces in giant cerebral aneurysms［J］. AJNR Am J Neuroradiol. 2003,24(9):1804-1810.

［9］Sadasivan C, Lieber B B, Gounis M J. Angiographic quantification of contrast medium washout from cerebral aneurysms after stent placement［J］. AJNR Am J Neuroradiol， 2002,23(7):1214-1221.

［10］Aenis M, Stancampiano A P, Wakhloo A K.Modeling of flow in a straight stented and nonstented side wall aneurysm model［J］. J Biomech Eng ，1997,119(2):206-212.

［11］Rhee K, Han M H, Cha S H. Changes of flow characteristics by stenting in aneurysm models: influence of aneurysm geometry and stent porosity［J］. Ann Biomed Eng， 2002,30(7):894-904.

［12］Imbesi S G， Kerber C W. Analysis of slipstream flow in two ruptured intracranial cerebral aneurysms［J］. AJNR Am J Neuroradiol,1999,20(9):1703-1705.

［13］Imbesi S G, Kerber C W. Analysis of slipstream flow in a wide-necked basilar artery aneurysm: evaluation of potential treatment regimens［J］. AJNR Am J Neuroradiol, 2001,22(4):721-724.

［14］Hoi Y, Meng H, Woodward S H. Effects of arterial geometry on aneurysm growth: three-dimensional computational fluid dynamics study［J］. J Neurosurg, 2004,101(4):676-681.

［15］Boecher-Schwarz H G, Ringel K, Kopacz L.Exvivo study of the physical effect of coils on pressure and flow dynamics in experimental aneurysms［J］. AJNR Am J Neuroradiol,2000,21(8):1532-1536.

［16］Wanke I, Doerfler A, Schoch B,et al. Treatment of widenecked intracranial aneurysms with a self-expanding stent system: initial clinical experience ［J］. AJNR, 2003, 24(6): 1192-1199.

［17］Wanke I, Forsting M. Stents for intracranial wide-necked aneurysms: more than mechanical protection ［J］. Neuroradiology,
2008, 50(12): 991-998.

［18］Vanninen R, Manninen H, Ronkainen A. Broad-based intracranial aneurysms thrombosis induced by stent placement［J］. AJNR, 2003, 24(2): 263-266.

［19］Yavuz K, Geyik S, Saatci I,et al. Wing span stent system in the endovascular treatment of intracranial aneurysms: clinical experience with midterm follow-up results ［J］. J Neurosurg,2008, 109(3): 445-453.

［20］Howington J U, Hanel R A, Harrigan M R,et al. The Neuroform stent, the first microcatheter-delivered stent for use in the intracranial circulation ［J］. Neurosurgery, 2004, 54(1):2-5.

［21］Chow M M, Woo H H, Masaryk T J,et al. A novel endovascular treatment of a wide-necked basilar apex aneurysm by using
a Y-configuration, double-stent technique ［J］. AJNR,2004, 25(3): 509-512.

［22］Thorell W E, Chow M M, Woo H H,et al. Y-configured dual intracranial stent-assisted coil embolization for the
treatment of wide-necked basilar tip aneurysms ［J］. Neurosurgery,2005, 56(5): 1035-1040.