Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Sole stenting of large and giant intracranial aneurysms with self-expanding intracranial stents-limits and complications

Pavliša, Goran and Ozretić, David and Murselović, Tamara and Pavliša, Gordana and Radoš, Marko (2010) Sole stenting of large and giant intracranial aneurysms with self-expanding intracranial stents-limits and complications. Acta Neurochirurgica, 152 (5). pp. 763-769. ISSN 0001-6268

[img]
Preview
PDF
Download (2243Kb) | Preview

    English abstract

    BACKGROUND: ----- Intracranial aneurysms may be difficult for endovascular treatment due to size, fusiform shape, or wide neck. In such patients, intracranial stents are used to support the coils in the aneurysm sac, or they may be used as a sole stenting technique to divert the blood flow without coils. The aim of this paper is to contribute to the existing data by reviewing the risks of sole stenting of large and giant aneurysms. METHODS: ----- We treated seven patients with nine aneurysms by self-expanding intracranial stents, either by a single or multiple stents in a stent-in-stent configuration. The follow-up was performed by digital subtraction angiography with a mean follow-up time of 6 months. RESULTS: ----- A positive response to stenting occurred in five out of seven patients (71%) and six out of nine aneurysms (67%). The aneurysms were occluded in two patients, and incomplete results were noted in three patients. The symptoms due to the compression of cranial nerves resolved in four patients (57%). Procedure-related subarachnoid hemorrhage occurred in two out of seven patients (29%), with death of one patient as a result of hemorrhage (14%). CONCLUSIONS: ----- Sole stenting of large and giant aneurysms with self-expanding intracranial stents may be associated with a higher risk than previously reported. The effect of stenting on intra-aneurysmal flow in such aneurysms, even after the placement of multiple overlapping stents, seems to be unpredictable.

    Item Type: Article
    MeSH: Adult ; Aged ; Aged, 80 and over ; Angiography, Digital Subtraction ; Brain Ischemia/epidemiology ; Brain Ischemia/physiopathology ; Brain Ischemia/prevention & control ; Cerebral Arteries/pathology ; Cerebral Arteries/radiography ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/instrumentation ; Embolization, Therapeutic/methods ; Fatal Outcome ; Female ; Humans ; Intracranial Aneurysm/complications ; Intracranial Aneurysm/pathology ; Intracranial Aneurysm/therapy ; Male ; Middle Aged ; Mortality ; Neuronavigation ; Postoperative Complications/epidemiology ; Postoperative Complications/physiopathology ; Postoperative Complications/prevention & control ; Prosthesis Implantation/adverse effects ; Prosthesis Implantation/instrumentation ; Prosthesis Implantation/methods ; Reoperation ; Retrospective Studies ; Risk Assessment ; Stents/adverse effects ; Stents/statistics & numerical data ; Stents/trends ; Subarachnoid Hemorrhage/epidemiology ; Subarachnoid Hemorrhage/physiopathology ; Subarachnoid Hemorrhage/prevention & control ; Treatment Outcome
    Divisions: Katedra za kirurgiju
    Katedra za radiologiju i opću kliničku onkologiju
    Depositing User: Marijan Šember
    Status: Published
    Creators:
    CreatorsEmail
    Pavliša, Goran
    Ozretić, David
    Murselović, Tamara
    Pavliša, Gordana
    Radoš, Marko
    Date: May 2010
    Date Deposited: 02 Dec 2011 10:05
    Last Modified: 02 Dec 2011 10:05
    Subjects: /
    Related URLs:
    URI: http://medlib.mef.hr/id/eprint/1408

    Actions (login required)

    View Item

    Document Downloads

    More statistics for this item...