Abstract
Introduction
The purpose of the study is to describe our experience in eight cases of horizontal stenting across the circle of Willis in patients with terminal aneurysms.
Methods
Eight patients were treated with horizontal stent placement and aneurysm coiling. All aneurysms had highly unfavourable dome to neck ratios. All patients were followed up with digital subtraction angiography at 3–12 months following treatment.
Results
The Enterprise stent was successfully deployed horizontally in vessels of less than 2-mm diameter with no stent occlusion. Neurological complications occurred in one patient. Immediate and follow-up angiographic results were encouraging with six stable occlusions at 6 months. There was one asymptomatic case of in-stent stenosis and one case of late organised in-stent thrombus.
Conclusions
Horizontal deployment of the Enterprise stent to assist coil embolisation of wide-necked terminal aneurysms is feasible. This device can be navigated via relatively small communicating arteries, in cases with favourable anatomy. Early angiographic results were favourable; however, longer-term follow-up will be required.
Similar content being viewed by others
References
Thorell WE, Chow MM, Woo HH et al (2005) Y-configured dual intracranial stent-assisted coil embolisation for the treatment of wide-necked basilar tip aneurysms. Neurosurgery 56(5):1035–1040
Cross DT, Moran CJ, Derdeyn CP et al (2005) Neuroform Stent Deployment for Treatment of a Basilar Tip Aneurysm via a Posterior Communicating Artery Route. AJNR Am J Neuroradiol 26:2578–2581
Benndorf G, Klucznik RP, Meyer D et al (2006) ‘Cross-over’ technique for horizontal stenting of an internal carotid bifurcation aneurysm using a new self-expandable stent: technical case report. Neurosurgery 58(1 Suppl):ONS-E172
Kelly ME, Turner R, Gonugunta V (2007) Stent reconstruction of wide-necked aneurysms across the circle of Willis. Neurosurgery 61(5(Suppl 2)):249–254
Wanke I, Gizewski E, Forsting M (2006) Horizontal stent placement plus coiling in a broad-based basilar tip aneurysm: an alternative to the Y-stent technique. Neuroradiology 48(11):817–820. doi:10.1007/s00234-006-0128-6
Debrun GM, Aletich VA, Kehrli P et al (1998) Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: the preliminary University of Illinois at Chicago experience. Neurosurgery 43:1281–1295. doi:10.1097/00006123-199812000-00011
Roy D, Milot G, Raymond J (2001) Endovascular treatment of unruptured aneurysms. Stroke 32:1998–2004. doi:10.1161/hs0901.095600
Moret J, Ross IB, Weill A et al (2000) The retrograde approach: a consideration for the endovascular treatment of aneurysms. AJNR Am J Neuroradiol 21(2):262–268
Higashida RT, Halbach VV, Dowd CF et al (2005) Initial clinical experience with a new self-expanding nitinol stent for the treatment of intracranial cerebral aneurysms: the Cordis Enterprise stent. AJNR Am J Neuroradiol 26:1751–1756
Schmahmann JD (2003) Vascular syndromes of the thalamus. Stroke 34:2264–2278. doi:10.1161/01.STR.0000087786.38997.9E
Conflict of interest statement
Dr Siddiqui has received sponsorship/funding to attend national and international conferences and courses from Boston Scientific Inc, Cordis Neurovascular, ev3 Inc. and Micrus Corporation over the last 5 years.
Dr Bhattacharya has received sponsorship/funding to attend national and international conferences and courses from Boston Scientific Inc, Cordis Neurovascular, ev3 Inc. and Micrus Corporation over the last 5 years.
Dr Jenkins has received sponsorship/funding to attend national and international conferences and courses from Boston Scientific Inc, Cordis Neurovascular, ev3 Inc., Micrus Corporation and Pyramed Limited over the last 5 years.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Siddiqui, M.A., J. Bhattacharya, J., W. Lindsay, K. et al. Horizontal stent-assisted coil embolisation of wide-necked intracranial aneurysms with the Enterprise stent—a case series with early angiographic follow-up. Neuroradiology 51, 411–418 (2009). https://doi.org/10.1007/s00234-009-0517-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00234-009-0517-8