The effect of Neuroform stent-assisted coil embolization of wide-necked intracranial aneurysms and clinical factors on progressive aneurysm occlusion on angiographic follow-up

J Clin Neurosci. 2013 Feb;20(2):244-7. doi: 10.1016/j.jocn.2012.01.053. Epub 2012 Nov 30.

Abstract

Stent-assisted coil embolization is an endovascular treatment for wide-necked intracranial aneurysms, but the durability of this treatment is not well known. The aim of this study is to investigate the effect of the Neuroform stent (Boston Scientific/Target, Fremont, CA, USA) in progressive occlusion of wide-necked intracranial aneurysms, and to assess any correlation between clinical factors and angiographic follow-up results. The records of 52 patients treated with a Neuroform stent were retrieved for analysis of population characteristics, initial and follow-up angiographic results, and clinical outcomes. Initial angiographic results showed complete occlusion in 21 (40.4%), neck remnants in 22 (42.3%), and residual aneurysms in nine (17.3%). Angiographic follow-up was available in 45 of 52 (86.5%) patients: complete occlusion was achieved in 32 (71.1%), neck remnants were present in eight (17.8%) and residual aneurysms in five (11.1%). Of 31 patients with immediate incomplete obliteration, progressive complete occlusion was achieved in 16 of 28 (57.1%) patients. Clinical follow-up showed good outcomes according to the modified Rankin Scale score. A univariate analysis showed that there was no effect of the tested clinical variables of patient age (p=0.823), gender (p=0.419), aneurysm location (p=0.394), size (p=0.625) and rupture status (p=0.721) on aneurysm occlusion at follow-up. We conclude that the Neuroform stent-assisted neck remodelling technique improves progressive occlusion of wide-necked intracranial aneurysms with good clinical outcomes.

MeSH terms

  • Adult
  • Aspirin / administration & dosage
  • Cerebral Angiography / methods
  • Clopidogrel
  • Disease Progression*
  • Embolization, Therapeutic / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / pathology
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents*
  • Ticlopidine / administration & dosage
  • Ticlopidine / analogs & derivatives
  • Treatment Outcome

Substances

  • Clopidogrel
  • Ticlopidine
  • Aspirin