Long-term results of enterprise stent-assisted coiling of cerebral aneurysms

Kyle M. Fargen, Brian L. Hoh, Babu G. Welch, G. Lee Pride, Giuseppe Lanzino, Alan S. Boulos, Jeffrey S. Carpenter, Ansaar Rai, Erol Veznedaroglu, Andrew Ringer, Rafael Rodriguez-Mercado, Peter Kan, Adnan Siddiqui, Elad I. Levy, J. Mocco

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

BACKGROUND: The Enterprise Vascular Reconstruction Device and Delivery System (Cordis; the Enterprise stent) was approved for use in conjunction with coiling of wide-necked aneurysms in 2007. No published long-term aneurysm occlusion or complication data exist for the Enterprise system. OBJECTIVE: We compiled data on consecutive patients treated with Enterprise stent-assisted coiling of aneurysms from 9 high-volume neurointerventional centers. METHODS: A 9 center registry was created to evaluate large volume data on the delayed safety and efficacy of the Enterprise stent system. Pooled data were compiled for consecutive patients undergoing Enterprise stent-assisted coiling at each institution prior to May 2009. RESULTS: Two-hundred twenty-nine patients with 229 aneurysms, 32 of which were ruptured aneurysms, were included in the study. Mean clinical and angiographic follow-up was 619.6 ± 26.4 days and 655.7 ± 25.2 days, respectively. Mean aneurysm size was 9.2 ± 0.4 mm. Fifty-nine percent of patients demonstrated 100% coil obliteration and 81% had 90% or higher occlusion at last follow-up angiography. A total of 19 patients (8.3%) underwent retreatment of their aneurysms during the follow-up period. Angiographic in-stent stenosis was seen in 3.4% and thromboembolic events occurred in 4.4%. Overall, 90% of patients who underwent Enterprise-assisted coiling had a modified Rankin Scale score of 2 or less at last follow-up. A poor modified Rankin Scale score was strongly associated with rupture status (P < .001). CONCLUSION: Although this study is limited by its retrospective nature, the Enterprise stent system appears to be an effective, safe, and durable treatment for intracranial aneurysms when used in conjunction with coiling.

Original languageEnglish (US)
Pages (from-to)239-244
Number of pages6
JournalNeurosurgery
Volume71
Issue number2
DOIs
StatePublished - Aug 2012

Fingerprint

Intracranial Aneurysm
Stents
Aneurysm
Ruptured Aneurysm
Retreatment
Blood Vessels
Registries
Rupture
Angiography
Pathologic Constriction
Safety
Equipment and Supplies

Keywords

  • Cerebral aneurysm
  • Cerebrovascular
  • Coiling
  • Endovascular
  • Enterprise
  • Stent

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Fargen, K. M., Hoh, B. L., Welch, B. G., Pride, G. L., Lanzino, G., Boulos, A. S., ... Mocco, J. (2012). Long-term results of enterprise stent-assisted coiling of cerebral aneurysms. Neurosurgery, 71(2), 239-244. https://doi.org/10.1227/NEU.0b013e3182571953

Long-term results of enterprise stent-assisted coiling of cerebral aneurysms. / Fargen, Kyle M.; Hoh, Brian L.; Welch, Babu G.; Pride, G. Lee; Lanzino, Giuseppe; Boulos, Alan S.; Carpenter, Jeffrey S.; Rai, Ansaar; Veznedaroglu, Erol; Ringer, Andrew; Rodriguez-Mercado, Rafael; Kan, Peter; Siddiqui, Adnan; Levy, Elad I.; Mocco, J.

In: Neurosurgery, Vol. 71, No. 2, 08.2012, p. 239-244.

Research output: Contribution to journalArticle

Fargen, KM, Hoh, BL, Welch, BG, Pride, GL, Lanzino, G, Boulos, AS, Carpenter, JS, Rai, A, Veznedaroglu, E, Ringer, A, Rodriguez-Mercado, R, Kan, P, Siddiqui, A, Levy, EI & Mocco, J 2012, 'Long-term results of enterprise stent-assisted coiling of cerebral aneurysms', Neurosurgery, vol. 71, no. 2, pp. 239-244. https://doi.org/10.1227/NEU.0b013e3182571953
Fargen KM, Hoh BL, Welch BG, Pride GL, Lanzino G, Boulos AS et al. Long-term results of enterprise stent-assisted coiling of cerebral aneurysms. Neurosurgery. 2012 Aug;71(2):239-244. https://doi.org/10.1227/NEU.0b013e3182571953
Fargen, Kyle M. ; Hoh, Brian L. ; Welch, Babu G. ; Pride, G. Lee ; Lanzino, Giuseppe ; Boulos, Alan S. ; Carpenter, Jeffrey S. ; Rai, Ansaar ; Veznedaroglu, Erol ; Ringer, Andrew ; Rodriguez-Mercado, Rafael ; Kan, Peter ; Siddiqui, Adnan ; Levy, Elad I. ; Mocco, J. / Long-term results of enterprise stent-assisted coiling of cerebral aneurysms. In: Neurosurgery. 2012 ; Vol. 71, No. 2. pp. 239-244.
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abstract = "BACKGROUND: The Enterprise Vascular Reconstruction Device and Delivery System (Cordis; the Enterprise stent) was approved for use in conjunction with coiling of wide-necked aneurysms in 2007. No published long-term aneurysm occlusion or complication data exist for the Enterprise system. OBJECTIVE: We compiled data on consecutive patients treated with Enterprise stent-assisted coiling of aneurysms from 9 high-volume neurointerventional centers. METHODS: A 9 center registry was created to evaluate large volume data on the delayed safety and efficacy of the Enterprise stent system. Pooled data were compiled for consecutive patients undergoing Enterprise stent-assisted coiling at each institution prior to May 2009. RESULTS: Two-hundred twenty-nine patients with 229 aneurysms, 32 of which were ruptured aneurysms, were included in the study. Mean clinical and angiographic follow-up was 619.6 ± 26.4 days and 655.7 ± 25.2 days, respectively. Mean aneurysm size was 9.2 ± 0.4 mm. Fifty-nine percent of patients demonstrated 100{\%} coil obliteration and 81{\%} had 90{\%} or higher occlusion at last follow-up angiography. A total of 19 patients (8.3{\%}) underwent retreatment of their aneurysms during the follow-up period. Angiographic in-stent stenosis was seen in 3.4{\%} and thromboembolic events occurred in 4.4{\%}. Overall, 90{\%} of patients who underwent Enterprise-assisted coiling had a modified Rankin Scale score of 2 or less at last follow-up. A poor modified Rankin Scale score was strongly associated with rupture status (P < .001). CONCLUSION: Although this study is limited by its retrospective nature, the Enterprise stent system appears to be an effective, safe, and durable treatment for intracranial aneurysms when used in conjunction with coiling.",
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AU - Fargen, Kyle M.

AU - Hoh, Brian L.

AU - Welch, Babu G.

AU - Pride, G. Lee

AU - Lanzino, Giuseppe

AU - Boulos, Alan S.

AU - Carpenter, Jeffrey S.

AU - Rai, Ansaar

AU - Veznedaroglu, Erol

AU - Ringer, Andrew

AU - Rodriguez-Mercado, Rafael

AU - Kan, Peter

AU - Siddiqui, Adnan

AU - Levy, Elad I.

AU - Mocco, J.

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N2 - BACKGROUND: The Enterprise Vascular Reconstruction Device and Delivery System (Cordis; the Enterprise stent) was approved for use in conjunction with coiling of wide-necked aneurysms in 2007. No published long-term aneurysm occlusion or complication data exist for the Enterprise system. OBJECTIVE: We compiled data on consecutive patients treated with Enterprise stent-assisted coiling of aneurysms from 9 high-volume neurointerventional centers. METHODS: A 9 center registry was created to evaluate large volume data on the delayed safety and efficacy of the Enterprise stent system. Pooled data were compiled for consecutive patients undergoing Enterprise stent-assisted coiling at each institution prior to May 2009. RESULTS: Two-hundred twenty-nine patients with 229 aneurysms, 32 of which were ruptured aneurysms, were included in the study. Mean clinical and angiographic follow-up was 619.6 ± 26.4 days and 655.7 ± 25.2 days, respectively. Mean aneurysm size was 9.2 ± 0.4 mm. Fifty-nine percent of patients demonstrated 100% coil obliteration and 81% had 90% or higher occlusion at last follow-up angiography. A total of 19 patients (8.3%) underwent retreatment of their aneurysms during the follow-up period. Angiographic in-stent stenosis was seen in 3.4% and thromboembolic events occurred in 4.4%. Overall, 90% of patients who underwent Enterprise-assisted coiling had a modified Rankin Scale score of 2 or less at last follow-up. A poor modified Rankin Scale score was strongly associated with rupture status (P < .001). CONCLUSION: Although this study is limited by its retrospective nature, the Enterprise stent system appears to be an effective, safe, and durable treatment for intracranial aneurysms when used in conjunction with coiling.

AB - BACKGROUND: The Enterprise Vascular Reconstruction Device and Delivery System (Cordis; the Enterprise stent) was approved for use in conjunction with coiling of wide-necked aneurysms in 2007. No published long-term aneurysm occlusion or complication data exist for the Enterprise system. OBJECTIVE: We compiled data on consecutive patients treated with Enterprise stent-assisted coiling of aneurysms from 9 high-volume neurointerventional centers. METHODS: A 9 center registry was created to evaluate large volume data on the delayed safety and efficacy of the Enterprise stent system. Pooled data were compiled for consecutive patients undergoing Enterprise stent-assisted coiling at each institution prior to May 2009. RESULTS: Two-hundred twenty-nine patients with 229 aneurysms, 32 of which were ruptured aneurysms, were included in the study. Mean clinical and angiographic follow-up was 619.6 ± 26.4 days and 655.7 ± 25.2 days, respectively. Mean aneurysm size was 9.2 ± 0.4 mm. Fifty-nine percent of patients demonstrated 100% coil obliteration and 81% had 90% or higher occlusion at last follow-up angiography. A total of 19 patients (8.3%) underwent retreatment of their aneurysms during the follow-up period. Angiographic in-stent stenosis was seen in 3.4% and thromboembolic events occurred in 4.4%. Overall, 90% of patients who underwent Enterprise-assisted coiling had a modified Rankin Scale score of 2 or less at last follow-up. A poor modified Rankin Scale score was strongly associated with rupture status (P < .001). CONCLUSION: Although this study is limited by its retrospective nature, the Enterprise stent system appears to be an effective, safe, and durable treatment for intracranial aneurysms when used in conjunction with coiling.

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KW - Cerebrovascular

KW - Coiling

KW - Endovascular

KW - Enterprise

KW - Stent

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