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The Stent-Assisted Coil-Jailing Technique Facilitates Efficient Embolization of Tiny Cerebral Aneurysms

  • Li, Cong-Hui (Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University) ;
  • Su, Xian-Hui (Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University) ;
  • Zhang, Bo (Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University) ;
  • Han, Yong-Feng (Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University) ;
  • Zhang, Er-Wei (Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University) ;
  • Yang, Lei (Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University) ;
  • Zhang, Dong-Liang (Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University) ;
  • Yang, Song-Tao (Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University) ;
  • Yan, Zhen-Quan (Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University) ;
  • Gao, Bu-Lang (Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University)
  • 투고 : 2014.06.14
  • 심사 : 2014.09.15
  • 발행 : 2014.12.01

초록

Objective: Tiny cerebral aneurysms are difficult to embolize because the aneurysm's sac is too small for a single small coil, and coils within the aneurysm may escape from the confinement of a stent. This study was performed to introduce the stent-assisted coil-jailing technique and to investigate its effect on the coil embolization of tiny intracranial aneurysms. Materials and Methods: Sixteen patients with tiny intracranial aneurysms treated with the stent-assisted coil-jailing technique between January 2011 and December 2013 were retrospectively reviewed and followed-up. Results: All aneurysms were successfully treated with the coil-jailing technique, and at the end of embolization, complete occlusion of the aneurysm was achieved in 9 cases (56.3%), incomplete occlusion in 6 (37.5%), and partial occlusion in 1 (6.3%). Intraprocedural complications included acute thrombosis in one case (6.3%) and re-rupture in another (6.3%). Both complications were managed appropriately with no sequela. Follow-up was performed in all patients for 3-24 months (mean, 7.7 months) after embolization. Complete occlusion was sustained in the 9 aneurysms with initial complete occlusion, progressive thrombosis to complete occlusion occurred in the 6 aneurysms with initial near-complete occlusion, and one aneurysm resulted in progressive thrombosis to complete occlusion after initial partial occlusion. No migration of stents or coils occurred at follow-up as compared with their positions immediately after embolization. At follow-up, all patients had recovered with no sequela. Conclusion: The stent-assisted coil-jailing technique can be an efficient approach for tiny intracranial aneurysms, even though no definite conclusion regarding its safety can be drawn from the current data.

키워드

참고문헌

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피인용 문헌

  1. Outcomes of Stent-assisted Coil Embolization of Wide-necked Intracranial Aneurysms Using the Solitaire™ AB Neurovascular Remodeling Device vol.17, pp.4, 2015, https://doi.org/10.7461/jcen.2015.17.4.301
  2. Stent-assisted embolization of wide-neck anterior communicating artery aneurysms: Review of consecutive 34 cases vol.50, pp.6, 2014, https://doi.org/10.1016/j.pjnns.2016.07.008
  3. Endovascular Treatment of Very Small Intracranial Aneurysms: Meta-Analysis vol.37, pp.5, 2014, https://doi.org/10.3174/ajnr.a4651
  4. Stent-assisted modified coil protection technique for bilobulated aneurysm: technical note vol.12, pp.1, 2014, https://doi.org/10.1016/j.radcr.2016.10.024