Background: Aneurysmal subarachnoid hemorrhage is a disabling disease. Endovascular coiling provides minimally invasive, effective, and safe treatment of both ruptured and unruptured intracranial aneurysms. Intracranial stents have improved the endovascular treatment of complex aneurysms, but the long-term durability of this treatment modality needs clarification.
Objective: To elucidate the long-term success of intracranial stent use in the treatment of aneurysms.
Methods: Four hundred ten patients were treated with stent-assisted endovascular management of 464 aneurysms. Treatment of 363 small aneurysms, 88 large aneurysms, and 13 giant aneurysms was analyzed with respect to both long-term anatomical results using digital subtraction (DSA) and magnetic resonance angiography (MRA) over the follow-up period.
Results: The six-month angiographic results of 387 aneurysm treatments revealed complete aneurysm occlusion in 282 (72.9%), residual aneurysm neck in 50 (12.9%), and residual aneurysm filling in 55 (14.2%). Long-term radiographic follow-up, performed in 262 patients (mean 3.63 years), showed significant recurrence of only three aneurysms after six-month follow-up imaging. Forty-eight aneurysms (11.9%) were considered radiographic failures during the follow-up period.
Conclusion: Aneurysm recurrence rate after stent-assisted embolization in this series was similar to published data using only coil embolization for the period between treatment and initial follow-up imaging. For aneurysms that do not initially recur, the presented data suggest improved durability in the subsequent, long-term follow-up period.
From: Long-Term Radiographic Results of Stent Assisted Embolization of Cerebral Aneurysms by Lopes et al.