Article
Safety and efficacy of a new self expandable stent system in the treatment of intracranial wide neck aneurysms
Sicherheit und Effizienz eines neuen selbstexpandierenden Stentsystems in der Behandlung von intrakraniellen breitbasigen Aneurysmen
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Published: | May 8, 2006 |
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Objective: To evaluate safety and efficacy of a new self-expandable stent system (Enterprise, Cordis, Miami, USA) in the treatment of intracranial wide neck aneurysms.
Methods: In a prospective study, 26 wide neck aneurysms (i.e. aneurysm neck >4mm, or dome-to-neck ratio <2) were treated with the Enterprise stent (Cordis, USA) in 25 patients (22 female, mean age 54, SD 7 years. They were located on the vertebral artery (n=1), basilar artery (n=5), internal carotid artery (n=13), anterior communicating artery (n=3), and middle cerebral artery (n=4). Mean aneurysm size was 6 x 7 x 7mm, and mean neck size was 5mm. Patients were pre-medicated with acetylsalicylic acid (100 mg) and Clopidogrel (75 mg) for at least 3 days. All procedures were performed under systemic heparinisation. Patients were clinically evaluated before and immediately after the procedure, at 30 days and 6 months after placement of the stent. Follow-up intra-arterial angiography was performed 6 months after treatment in 24 patients.
Results: Stent placement was feasible in all cases without technical problems. In particular, navigation of the stent through elongated vessels and stent retrieval was unproblematic. During the procedure, there was no vasospasm or coil prolapse into the parent vessel. One patient, who was thereafter diagnosed as being Clopidogrel-resistant, developed a stent thrombosis without long-term clinical sequelae. Aneurysm recanalization at six months was present in four patients needing re-treatment in three cases. Progressive occlusion of the aneurysm was observed in five cases. One patient refused to come to the 6-month follow-up.
Conclusions: These data suggest a safe and feasible application of the Enterprise stent system. The low rate of recanalization in this group of wide neck aneurysms is promising.