J Cerebrovasc Endovasc Neurosurg.  2013 Sep;15(3):158-163. 10.7461/jcen.2013.15.3.158.

Clinical and Angiographic Outcomes of Wide-necked Aneurysms Treated with the Solitaire AB Stent

• Lee SY
• Chae KS
• Rho SJ
• Choi HK
• Park HS
• Ghang CG

• KMID: 1491433
• DOI: http://doi.org/10.7461/jcen.2013.15.3.158

Abstract

OBJECTIVE
This study investigated the clinical and angiographic outcomes of treatment with stent-assisted coil embolization using the Solitaire AB stents for wide-necked intracranial aneurysms.
METHODS
From October 2010 to December 2011, 22 patients with aneurysms were treated with the Solitaire AB stent. One patient with a dissecting aneurysm was excluded, thus 21 patients with 21 wide-necked saccular aneurysms were included in this study. The technical success rate, procedure-related complications, initial and follow-up angiographic results, and clinical outcomes were retrospectively collected.
RESULTS
The locations of aneurysms were as follows: paraclinoid in 14, distal internal carotid artery in 4, and vertebral artery in 3 patients. All aneurysms were unruptured and less than 10 mm-sized. The mean dome-to-neck ratio of the aneurysms was 1.00 (range: 0.45-1.81). The mean follow-up duration was 12.1 (7-15) months after the initial procedure. The technical success rate was 21 (95.5%) of 22 patients with aneurysms. Fortunately, there were no procedure-related complications. Follow-up angiography showed that the rate of complete occlusion was 57.1%, neck remnants 38.1%, and incomplete occlusion 4.8%.
CONCLUSION
We suggest that using Solitaire AB stent is technically feasible and safe in the stent-assisted coil embolization for wide-necked saccular intracranial aneurysms. To evaluate the long-term effects of this stent, further follow-up angiography is needed.

Keyword

Solitaire stent; Coil embolization; Wide-necked aneurysm

MeSH Terms

Aneurysm
Aneurysm, Dissecting
Angiography
Carotid Artery, Internal
Follow-Up Studies
Humans
Intracranial Aneurysm
Neck
Retrospective Studies
Stents
Vertebral Artery

Figure

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  Fig. 1 Patient No. 11: A 60-year-old woman with unruptured aneurysm of a tortuous left distal internal carotid artery (ICA) is treated with coil embolization. (A) The aneurysm is shown on left ICA angiography. (B) A Solitaire stent is positioned at the left distal ICA (white arrow: proximal and distal stent marker). (C) Immediate left ICA angiography after embolization shows no contrast filling of the aneurysmal neck or dome. (D) Twelve months after embolization, angiography shows no recanalization.

• 

  Fig. 2 Patient No.8: A 55-year-old woman with an unruptured aneurysm of the left distal internal carotid artery (ICA) was treated with coil embolization by repositioning the stent. (A) ICA angiography shows that the stent marker was outside the vessel. (B) The stent was pulled out slightly and the stent marker was moved back inside the vessel.

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