gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Treatment of intracranial aneurysms by flow-modifying stents and stent-assisted coil-embolisation: a single center's retrospective 10-year analysis

Meeting Abstract

  • Philippe Dodier - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, Österreich
  • Hendrik Falz - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, Österreich
  • Wei-Te Wang - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, Österreich
  • Andreas Gruber - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, Österreich
  • Engelbert Knosp - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, Österreich
  • Gerhard Bavinzski - Universitätsklinik für Neurochirurgie, Medizinische Universität Wien, Österreich

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.05.08

doi: 10.3205/14dgnc305, urn:nbn:de:0183-14dgnc3055

Published: May 13, 2014

© 2014 Dodier et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Presentation of our experience in the treatment of intracranial aneurysms by stent implantation and stent-assisted coil embolisation.

Method: Retrospective analysis of intracranial aneurysm patients, endovascularly treated between 2003 and 2013 by flow modification (stents, flow diverting stents and stent-assisted coil embolization). Configuration, size, location of the aneurysm and clinical data were collected. The follow-up analysis of the occlusion rates was evaluated by angiography, CTA, MRA according to the Raymond classification. The clinical neurological outcome was assessed using the modified Rankin Scale.

Results: Between May 2003 and July 2013, a total of 156 endovascular stent treatments of 147 patients (111 women, 36 men) with a mean age of 53.4 years (range 24–82 J), were performed at our department. 72,1% (n=116) of all aneurysms were located in the anterior, 27,9% (n=43) in the posterior circulation. Incidental aneurysms represented 69% (n=108), multiple (≥2) aneurysms 25% (n=40) of all cases. A bleeding history (rupture or St.p. SAH) was documented in 24,5% (n=6). Stent-assisted coiling was performed in 96 cases, of which 51 procedures happened two-staged. 23 flow diverters were implanted. 16 stent-alone procedures were documented. Raymond I+II occlusion rates were achieved in 86,2% of cases.

2 serious complications (mRS 6, rebleeding after stent implantation) were documented, a third patient died of pulmonary embolism. 135 patients had satisfactory neurological outcomes of mRS ≤2

Conclusions: The long-term follow-up data of our series show satisfactory progressive thrombosis and occlusion rates of stent and stent-assisted treatment of complex intracranial aneurysms. This endovascular treatment has been established as a low morbidity treatment option of complex, wide-necked aneurysms and is increasingly performed in proximal and difficult to reach aneurysms (ACI, A. vertebral, Basilar A.).

Indication, treatment success, long-term follow-up as well as pitfalls (complications) of the past 10 years are presented.