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Frequency and predictors of endoleaks and long-term patency after covered stent placement for the treatment of intracranial aneurysms: a prospective, non-randomised multicentre experience

  • Vascular-Interventional
  • Published:
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Abstract

Objective

We investigated immediate/late endoleaks and long-term patency following stent-graft placement for treatment of intracranial aneurysms located within the distal internal carotid artery (ICA) or vertebral artery (VA).

Methods

Forty-five aneurysms in 41 patients receiving covered stents in three centres were followed. Outcome measures included aneurysm occlusion rate, endoleaks, late in-stent stenosis rate, clinical improvement, neurological deficiencies and death.

Results

Total aneurysm exclusion was achieved in 69.2% (n = 27), with 30.8% (n = 12) experiencing immediate residual endoleaks. Angiographic follow-up (mean 43.5 ± 14.3 months) revealed that 87.2% (n = 34) were completely occluded with only 12.8% (n = 5) showing residual endoleaks. Predictors of immediate endoleaks in our patient group were stent number (P = 0.023) and stent diameter (P = 0.022), while predictors of late endoleaks in our patient group were stent diameter (P = 0.035) and stent angulation (P = 0.021). Late in-stent stenosis rates were 18.0 ± 13.3 and 29.0 ± 18.5% compared with the period immediately following implantation at 2- and 6-year follow-ups respectively. Smoking (P = 0.017) and stent angulation (P = 0.020) were predictors of late in-stent stenosis.

Conclusion

Treating intracranial aneurysms with Willis stent-grafts has an acceptable immediate and late occlusion rate and long-term stented artery patency rate.

Key Points

• Covered stents can be a treatment option for intracranial aneurysms.

• Technical success for treating distal ICA and VA aneurysms can reach 97.6%.

• However immediate and late endoleaks occur in 30.8 and 12.8% respectively.

• The number, diameter and angulation of stents are possible predictors of endoleaks.

• Smoking and stent angulation seem to predict late in-stent stenosis.

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Acknowledgements

This study is supported by the National Natural Science Foundation of China (No. 81000652), Shanghai Venus Program Funds (No. 11QA1405000).

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, The Sixth Affiliated People’s Hospital, Medical School of Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai, 200233, China

    Yue-Qi Zhu, Ming-Hua Li, Hua-Qiao Tan, Bin-Xian Gu & Pei-Lei Zhang

  2. Department of Neurosurgery, Capital Medical University Affiliated Xuanwu Hospital, No. 45, Changchun Street, Beijing, 100053, China

    Feng Lin, Hong-Qi Zhang & Bin Leng

  3. Department of Neurosurgery, Fudan University Affiliated Huashan Hospital, No. 12, Wulumuqi Road, Shanghai, 200040, China

    Dong-Lei Song

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  1. Yue-Qi Zhu
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  2. Ming-Hua Li
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Correspondence to Ming-Hua Li.

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Zhu, YQ., Li, MH., Lin, F. et al. Frequency and predictors of endoleaks and long-term patency after covered stent placement for the treatment of intracranial aneurysms: a prospective, non-randomised multicentre experience. Eur Radiol 23, 287–297 (2013). https://doi.org/10.1007/s00330-012-2581-4

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  • DOI: https://doi.org/10.1007/s00330-012-2581-4

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