Introduction Balloon assistance for endovascular management of intracranial aneurysms is an established technique. There are possible limitations to this technique related to either anatomical or functional factors (patient intolerance to baloon occlusion). The authors present their experience using a retrievable intracranial stent as an assistive device for either coiling of aneurysms or navigation or microcatheters in difficult anatomy.
Methods A total of three patients underwent neurointerventions using a retrievable stent assistance technique. Two patients had intracranial aneurysms, one at the posterior communicating segment level and the other supraclinoid. An additional patient with a posterior circulation AVM underwent stent-assisted navigation of a microcatheter for Onix embolization of the malformation. In all cases the stent was partially deployed and used only to assist either in coil placement or in navigation of the microcatheter through a tortuous PICA. In one aneurysm case the carotid was anatomically isolated, therefore it has been percieved that temporary baloon occlusion might be exposing the patient to irreversible ischemia. In the other aneurysm case the intent was to withdraw the stent after assistance due to possible difficult post-op management of antiplatelet therapy. In the AVM case the stent was used after and attempt of using balloon assistance for navigation failed. None of the patients who underwent stent assistance, received antiplatelets in advance. Should the stent not have been retrieved, emergent antiplatelet therapy would have been initiated.
Results In all three cases the stent was retrieved successfully and contributed to effective management of the case. There were no complications related to the stent usage.
Conclusion The usage of stent assistance in neurointerventional cases has a potential use for situations in which balloon assistance is not possible or unsuccessful. A larger series of cases is however necessary to demonstrate safety and reproducibility of this technique
Competing interests None.
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