PT  - JOURNAL ARTICLE
AU  - Christopher S Ogilvy
AU  - Sabareesh K Natarajan
AU  - Shady Jahshan
AU  - Yuval Karmon
AU  - Xinyu Yang
AU  - Kenneth V Snyder
AU  - L Nelson Hopkins
AU  - Adnan H Siddiqui
AU  - Elad I Levy
TI  - Stent-assisted coiling of paraclinoid aneurysms: risks and effectiveness
AID  - 10.1136/jnis.2010.002303
DP  - 2011 Mar 01
TA  - Journal of NeuroInterventional Surgery
PG  - 14--20
VI  - 3
IP  - 1
4099  - http://jnis.bmj.com/content/3/1/14.short
4100  - http://jnis.bmj.com/content/3/1/14.full
SO  - J NeuroIntervent Surg2011 Mar 01; 3
AB  - Background Stent assistance for treatment of wide-based aneurysms is becoming rapidly accepted.Methods Cases of aneurysms arising in the paraclinoid location of the internal carotid artery treated with intracranial stents and/or bare platinum coils were analyzed retrospectively from our prospectively collected database. We identified 70 aneurysms treated with stent assistance (including one stenting-alone case) and 24 aneurysms treated with coiling alone. Stenting-assisted coiling was achieved either as a one-time treatment or as a two-step maneuver with the stent placed several weeks before coiling, or stent-assisted coiling was used as a second maneuver in aneurysms that recanalized after previous coiling.Results In aneurysms treated with stent assistance, 60% had ≥95% occlusion at treatment completion, a result comparing favorably with the 54.2% rate of ≥95% occlusion associated with coiling alone. At last follow-up, 60 aneurysms treated with stent assistance had a 66.7% incidence of ≥95% occlusion, with no in-stent stenosis; 75% of patients treated with coiling alone had ≥95% aneurysm occlusion. Thrombus occurred during stent deployment in two patients, one with and one without neurologic sequelae; stent displacement occurred in one patient without neurologic sequelae. At last follow-up, 57 of 62 patients (91.9%) treated with stent-assisted coiling experienced excellent/good outcomes (modified Rankin scale score ≤2). These results compared favorably with those for the coiling-alone group in which 23 of 24 (95.8%) had good outcomes.Conclusion Stent-assisted coiling of paraclinoid aneurysms did not add significantly to morbidity; overall effectiveness was comparable to that of bare coiling of paraclinoid aneurysms. These results require confirmation by a prospective controlled trial.