Preliminary experience with self-expanding closed-cell stent placement in small arteries less than 2 mm in diameter for the treatment of intracranial aneurysms

J Neurosurg. 2015 Jun;122(6):1503-10. doi: 10.3171/2014.11.JNS14435. Epub 2015 Jan 2.

Abstract

Object: The purpose of this study was to report the authors' preliminary experience using self-expanding closed-cell stents deployed in small arteries (< 2 mm in diameter) to treat intracranial aneurysms.

Methods: A total of 31 patients were studied. All subjects met the following criteria: 1) they received an Enterprise stent for treatment of a wide-necked aneurysm or a dissecting aneurysm or as part of a stent-salvage procedure; and 2) they had an Enterprise stent deployed in a small parent artery (< 2 mm in diameter) that had no atherosclerotic stenosis. Procedure-related complications and follow-up sizes of the parent arteries were evaluated for safety and patency.

Results: There were 16 ruptured aneurysms and 15 unruptured aneurysms. Three (9.7%) of the 31 patients experienced procedure-related complications, and they all were asymptomatic. Follow-up angiography was performed in 27 patients (87.1%) (at a mean 15.5 months after surgery). Parent arteries with 2 acute angles (n = 4) were occluded in 3 cases (75.0%), and those with no acute angles (n = 13) or 1 acute angle (n = 6) showed 100% patency on follow-up angiography. There was a significant difference between the follow-up sizes (mean 1.72 ± 0.30 mm) of parent arteries and their sizes (mean 1.59 ± 0.26 mm) before treatment (95% CI - 0.254 to - 0.009 mm; p = 0.037, paired-samples t-test).

Conclusions: In the current series the deployment of self-expanding closed-cell stents in small arteries was safe and resulted in good patency, especially when the stents were deployed in segments of the parent artery with no acute angles or only 1 acute angle.

Keywords: DSA = digital subtraction angiography; EVT = endovascular treatment; Enterprise stent; GOS = Glasgow Outcome Scale; LVIS = Low-Profile Visualized Intraluminal Stent; closed-cell stent; intracranial aneurysm; self-expanding stent; small parent vessels; vascular disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured / surgery*
  • Female
  • Humans
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Stents*
  • Treatment Outcome