Intracranial stenting in patients with atherosclerotic stenosis associated with various aneurysms in the same diseased arterial segment

AJNR Am J Neuroradiol. 2010 Nov;31(10):1895-8. doi: 10.3174/ajnr.A2208. Epub 2010 Jul 29.

Abstract

Background and purpose: Aneurysms are rarely associated with symptomatic intracranial stenosis. We report the results of recanalization by stent placement in patients with symptomatic severe intracranial stenosis associated with adjacent aneurysms.

Materials and methods: Of 139 patients who underwent intracranial stent placement during a 5-year period, 10 (7%) had symptomatic severe intracranial stenosis associated with adjacent aneurysms. Five were in the VA, 3 in the BA, and 2 in M1. The types of aneurysm were atherosclerotic fusiform (n = 5), ulcerative (n = 4), and saccular (n = 1). We analyzed angiographic findings based on biplane and 3D angiograms and assessed patient outcomes and complications after stent placement. The results were compared with those of a control group without aneurysms who underwent stent placement during the same study period.

Results: Aneurysm locations were post- (n = 6), in- (n = 2), and pre-stenotic (n = 2). After angioplasty with stent placement and/or aneurysm embolization, there were no lesion-related strokes or deaths during a median follow-up period of 25 months (range, 11-43 months). One patient had asymptomatic restenosis. The final mRS score was good (≤2) in all patients. There were no statistically significant differences in event or restenosis rates compared with the control group.

Conclusions: Adjacent aneurysms were rarely associated with severe intracranial stenosis but were more common in the posterior circulation. Intracranial stent placement may be performed without additional stroke risk, regardless of the type and location of the aneurysm.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon / methods*
  • Cerebral Angiography
  • Embolization, Therapeutic
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / epidemiology
  • Intracranial Aneurysm / therapy*
  • Intracranial Arteriosclerosis / diagnostic imaging
  • Intracranial Arteriosclerosis / epidemiology
  • Intracranial Arteriosclerosis / therapy*
  • Male
  • Middle Aged
  • Risk Factors
  • Severity of Illness Index
  • Stents*
  • Stroke / epidemiology
  • Stroke / prevention & control
  • Vertebral Artery Dissection / diagnostic imaging
  • Vertebral Artery Dissection / epidemiology
  • Vertebral Artery Dissection / therapy*