Stent salvage using the Enterprise stent for procedure-related complication during coil embolization of ruptured intracranial aneurysms

Acta Neurochir (Wien). 2013 Feb;155(2):223-9. doi: 10.1007/s00701-012-1528-5. Epub 2012 Nov 10.

Abstract

Background: Despite accumulated experience and improved understanding of the tools, endovascular treatment of intracranial aneurysms continues to have risks linked to the technique itself, and induces procedure-related complications. The purpose of this study was to report our series of stent salvage using the Enterprise stent for procedure-related complication during coil embolization in patients with ruptured intracranial aneurysms.

Methods: Parent artery thrombosis, parent artery dissection, and coil protrusion were considered to be the procedure-related complications. There were 18 consecutive cases (3 unruptured and 15 ruptured aneurysms) with procedure-related complications rescued by the Enterprise stent from December 2008 to December 2011. Follow-up angiography was performed in 14 of the 15 patients with ruptured aneurysms between 6 and 30 months (mean 14.6 months) after the procedure.

Results: The procedure-related complications were parent artery dissection (n = 1), parent artery thrombosis (n = 4), and coil protrusion (n = 10). There was no complication related to delivering or deploying of the Enterprise stent. Initial radiographic results showed 8 cases of complete occlusion and 7 cases of neck remnant. There was no change in the angiographic results during the follow-up periods.

Conclusions: Facing with procedure-related complications during coil embolization of ruptured intracranial aneurysms, the closed-cell designed Enterprise stent might be a useful option for the salvage technique by restoring blood flow and minimizing thromboembolic events.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm, Ruptured / complications
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / therapy*
  • Blood Vessel Prosthesis Implantation / adverse effects*
  • Blood Vessel Prosthesis*
  • Cohort Studies
  • Embolization, Therapeutic / adverse effects*
  • Equipment Design
  • Female
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Stents*
  • Treatment Outcome