Browse > Article
http://dx.doi.org/10.3340/jkns.2009.46.6.545

Sole Stenting Technique for Treatment of Complex Aneurysms  

Kim, Young-Joon (Department of Neurosurgery, Dankook University College of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.46, no.6, 2009 , pp. 545-551 More about this Journal
Abstract
Objective : Complex aneurysms such as fusiform and very small aneurysms (< 3 mm) are challenging in neurovascular and endovascular surgery. Author reports follow-up results of 9 cases treated by sole stent technique with pertinent literature review. Methods : A retrospective study was made of 9 patients who were treated by sole stenting technique for cerebral aneurysm between January 2003 and January 2009. Two of them had fusiform aneurysm, 5 had very small aneurysm, and 2 had small saccular aneurysm. Five patients had ruptured aneurysms and four had unruptured aneurysms. Seven aneurysms were located in the internal carotid artery (ICA), 1 in the middle cerebral artery (MCA) and 1 in the basilar artery. Follow-up cerebral angiography was performed at post-procedure 3 months, 6 months, and 12 months. Mean follow-up period is 30 months (ranged from 3 days to 30 months). Results : Aneurysm size was decreased in 6 of 9 cases on follow-up images and was not changed in 3 cases. Although total occlusion was not seen, patients had stable neurological condition and angiographic result. The procedural complication occurred in 2 cases. One was coil migration and the other was suboptimal deployment of stent, and both were asymptomatic. Re-bleeding and thromboembolic complication had not been occurred. Conclusion : Sole stenting technique is relatively effective and safe as an alternative treatment for fusiform and very small aneurysms.
Keywords
Sole stenting technique; Fusiform aneurysm; Very small aneurysm;
Citations & Related Records

Times Cited By Web Of Science : 1  (Related Records In Web of Science)
Times Cited By SCOPUS : 0
연도 인용수 순위
  • Reference
1 Chiaradio JC, Guzman L, Padilla L, Chiaradio MP : Intravascular graft stent treatment of a ruptured fusiform dissecting aneurysm of the intracranial vertebral artery : technical case report. Neurosurgery 50 : 213-216, 2002   DOI   ScienceOn
2 Fiorella D, Albuquerque FC, Deshmukh VR, Woo HH, Rasmussen PA, Masaryk TJ, et al. : Endovascular reconstruction with the Neuroform stent as monotherapy for the treatment of uncoilable intradural pseudoaneurysms. Neurosurgery 59 : 291-300, 2006   DOI   ScienceOn
3 Kaku Y, Yoshimura S, Yamakawa H, Sakai N : Failure of stentassisted endovascular treatment for ruptured dissecting aneurysms of the basilar artery. Neuroradiology 45 : 22-26, 2003   DOI   ScienceOn
4 Kim YJ : Early experiences of neruoform stent-assisted coiling in ruptured intracranial aneurysms. Interv Neuroradiol 13 : 31-44, 2007
5 Kim M, Levy EI, Meng H, Hopkins LN : Quantification of hemodynamic changes induced by virtual placement of multiple stents across a wide-necked basilar trunk aneurysm. Neurosurgery 61 : 1305-1312, 2007   DOI   ScienceOn
6 Levy EI, Boulos AS, Bendok BR, Kim SH, Qureshi AI, Guterman LR, et al. : Brainstem infarction after delayed thrombosis of a stented vertebral artery fusiform aneurysm : case report. Neurosurgery 51 : 1280-1284, 2002   DOI   ScienceOn
7 Pumar JM, Lete I, Pardo MI, V$\acute{a}$zquez-Herrero F, Blanco M : LEO stent monotherapy for the endovascular reconstruction of fusiform aneurysms of the middle cerebral artery. Am J Neuroradiol 29 : 1775-1776, 2008   DOI   ScienceOn
8 Vanninen R, Manninen H, Ronkainen A : Broad-based intracranial aneurysms : thrombosis induced by stent placement. Am J Neuroradiol 24 : 263-266, 2003   ScienceOn
9 Wakhloo AK, Mandell J, Gounis MJ, Brooks C, Linfante I, Winer J, et al. : Stent-assisted reconstructive endovascular repair of cranial fusiform atherosclerotic and dissecting aneurysms : long-term clinical and angiographic follow-up. Stroke 39 : 3288-3296, 2008   DOI   ScienceOn
10 Yavuz K, Geyik S, Saatci I, Cekirge HS : WingSpan Stent System in the endovascular treatment of intracranial aneurysms : clinical experience with midterm follow-up results. J Neurosurg 109 : 445-453, 2008   DOI   ScienceOn
11 Mehta B, Burke T, Kole M, Bydon A, Seyfried D, Malik G : Stentwithin-a-stent technique for the treatment of dissecting vertebral artery aneurysms. Am J Neuroradiol 24 : 1814-1818, 2003   ScienceOn
12 Zenteno MA, Santos-Franco JA, Freitas-Modenesi JM, G$\acute{o}$mez C, Murillo-Bonilla L, Aburto-Murrieta Y, et al. : Use of the sole stenting technique for the management of aneurysms in the posterior circulation in a prospective series of 20 patients. J Neurosurg 108 : 1104-1118, 2008   DOI   ScienceOn
13 Rhee K, Han MH, Cha SH : Changes of flow characteristics by stenting in aneurysm models : influence of aneurysm geometry and stent porosity. Ann Biomed Eng 30 : 894-904, 2002   DOI   ScienceOn
14 Drake C, Peerless S : Giant fusiform intracranial aneurysm : review of 120 patients treated surgically from 1965-1992. J Neurosurg 87 : 141-162, 1997   DOI   ScienceOn
15 Lopes D, Sani S : Histological postmortem study of an internal carotid artery aneurysm treated with the Neuroform stent. Neurosurgery 56 : E416, 2005   DOI
16 Mohr JP, Choi D, Grotta J, Wolf P : Stroke : Pathophysiology, Diagnosis, and Management, 4th ed. Philadelphia, Churchill Livingson, 2004, pp 1318
17 Mizutani T, Kojima H, Asamoto S, Miki Y : Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms. Neurosurgery 36 : 905-913, 1995   DOI   ScienceOn
18 Wakhloo AK, Tio FO, Lieber BB, Schellhammer F, Graf M, Hopkins LN : Self-expanding nitinol stents in canine vertebral arteries : hemodynamics and tissue response. Am J Neuroradiol 16 : 1043-1051, 1995   ScienceOn
19 Debrun G, Fox AJ, Drake CG, Peerless S, Girvin J, Ferguson G : Giant unclippable aneurysm : treatment with detachable balloons. Am J Neuroradiol 2 : 167-173, 1981   ScienceOn
20 Lylyk P, Cohen JE, Ceratto R, Ferrario A, Miranda C : Combined endovascular treatment of dissecting vertebral artery aneurysms by using stents and coils. J Neurosurg 94 : 427-432, 2001   DOI   ScienceOn
21 Benndorf G, Herbon U, Sollmann WP, Campi A : Treatment of a ruptured dissecting vertebral artery aneurysm with double stent placement : case report. Am J Neuroradiol 22 : 1844-1848, 2001   ScienceOn
22 Jamous MA, Satoh K, Matsubara S, Satomi J, Nakajima N, Uno M, et al. : Ischemic basilar artery dissecting aneurysm treated by stenting only. Case report. Neurol Med Chir (Tokyo) 44 : 77-81, 2004   DOI   ScienceOn
23 Ahn JY, Han IB, Kim TG, Yoon PH, Lee YJ, Lee BH, et al. : Endovascular treatment of intracranial vertebral artery dissections with stent placement or stent-assisted coiling. Am J Neuroradiol 27 : 1514-1520, 2006   ScienceOn
24 Steinberg GK, Drake CG, Peerless SJ : Deliberate basilar or vertebral artery occlusion in the treatment of intracranial aneurysms. Immediate results and long-term outcome in 201 patients. J Neurosurg 79 : 161-173, 1993   DOI   ScienceOn
25 Chen Z, Feng H, Tang W, Liu Z, Miao H, Zhu G : Endovascular treatment of very small intracranial aneurysms. Surg Neurol 70 : 30-35, 2008   DOI   ScienceOn
26 Fiorella D, Albuquerque FC, Woo H, Rasmussen PA, Masaryk TJ, McDougall CG : Neuroform in-stent stenosis : incidence, natural history, and treatment strategies. Neurosurgery 59 : 34-42, 2006   DOI   ScienceOn
27 Masuo O, Terada T, Walker G, Tsuura M, Matsumoto H, Tohya K, et al. : Study of the patency of small arterial branches after stent placement with an experimental in vivo model. Am J Neuroradiol 23 : 706-710, 2002   ScienceOn
28 Doerfler A, Wanke I, Egelhof T, Stolke D, Forsting M : Doublestent method : therapeutic alternative for small wide-necked aneurysms. Technical note. J Neurosurg 100 : 150-154, 2004   DOI   ScienceOn
29 Lubicz B, Collignon L, Lefranc F, Bruneau M, Brotchi J, Bal$\acute{e}$riaux D, et al. : Circumferential and fusiform intracranial aneurysms : reconstructive endovascular treatment with self-expandable stents. Neuroradiology 50 : 499-507, 2008   DOI   ScienceOn
30 Albuquerque FC, Fiorella DJ, Han PP, Deshmukh VR, Kim LJ, McDougall CG : endovascular management of intracranial vertebral artery dissecting aneurysms. Neurosurg Focus 18 : E3, 2005
31 Gobin YP, Vi$\tilde{n}$uela F, Gurian JH, Guglielmi G, Duckwiler GR, Massoud TF, et al. : Treatment of large and giant fusiform intracranial aneurysms with Guglielmi detachable coils. J Neurosurg 84 : 55-62, 1996   DOI   ScienceOn
32 Lopes DK, Ringer AJ, Boulos AS, Qureshi AI, Lieber BB, Guterman LR, et al. : Fate of branch arteries after intracranial stenting. Neurosurgery 52 : 1275-1278, 2003   DOI   ScienceOn
33 Ansari SA, Thompson BG, Gemmete JJ, Gandhi D : Endovacular treatment of distal cervical and intracranial dissection with the neuroform stent. Neurosurgery 62 : 636-646, 2008   DOI   ScienceOn