Evaluation of Enterprise Stent-Assisted Coiling and Telescoping Stent Technique as Treatment of Supraclinoid Blister Aneurysms of the Internal Carotid Artery

Ding Xu, Changwei Zhang, Ting Wang, Chaohua Wang, David F. Kallmes, Giuseppe Lanzino, Chao You, Xiaodong Xie

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: Supraclinoid blister aneurysms (BAs) of the internal carotid artery are uncommon and deadly, and appropriate treatment is controversial. Endovascular reconstruction may allow treatment through aneurysm isolation. We report a single-institution experience in the use of Enterprise stent-assisted coiling (ESAC) for treating BAs to appraise the safety and efficacy of this technique. Methods: Patients treated with ESAC for a BA at our institution between 2013 and 2016 were retrospectively included in this study. Patients’ aneurysm characteristics, progression status, aneurysm occlusion on follow-up angiography, and modified Rankin Scale (mRS) score were recorded and analyzed. Occlusion rates and neurologic outcomes were compared between patients treated with a single stent and those treated with multiple telescoping stents. Results: Forty-four patients were included (17 males; average age, 47.3 years), and ESAC was successfully performed in all patients. Immediate postprocedure angiography revealed complete occlusion in 23 patients (52.3%), residual neck in 15 (34.1%), and residual aneurysm in 6 (13.6%). Twenty patients (45.5%) suffered perioperative cerebral vasospasm, and 3 (6.8%) died of secondary ischemic stroke. The duration of follow-up ranged from 2.5 to 27 months (mean, 11.59 ± 5.76 months). One patient with recurrence was treated with additional coiling, and another patient was treated with a covered stent. The use of telescoping stents was associated with a better complete aneurysm occlusion rate compared with the use of single stents (84.4% [27 of 34] vs. 44.4% [4 of 9]; P = 0.04). Follow-up mRS score was ≤1 for 32 of 41 patients (78.4%). Conclusions: ESAC to treat BAs is safe, effective, and provides good clinical outcomes. ESAC with telescoping stents has a higher follow-up complete occlusion rate compared with ESAC with single stents.

Original languageEnglish (US)
Pages (from-to)e890-e896
JournalWorld neurosurgery
Volume110
DOIs
StatePublished - Feb 2018

Keywords

  • Blister aneurysm
  • Coiling
  • Stent
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Evaluation of Enterprise Stent-Assisted Coiling and Telescoping Stent Technique as Treatment of Supraclinoid Blister Aneurysms of the Internal Carotid Artery'. Together they form a unique fingerprint.

  • Cite this