J Cerebrovasc Endovasc Neurosurg.  2013 Dec;15(4):299-306. 10.7461/jcen.2013.15.4.299.

A Self-expanding Nitinol Stent (Enterprise) for the Treatment of Wide-necked Intracranial Aneurysms: Angiographic and Clinical Results in 40 Aneurysms

• Kim ST
• Jeong HW
• Jeong YG
• Heo YJ
• Seo JH
• Paeng SH

• KMID: 1810788
• DOI: http://doi.org/10.7461/jcen.2013.15.4.299

Abstract

OBJECTIVE
Self-expanding stents are increasingly used for the treatment of complex intracranial aneurysms. The purpose of this study was to evaluate the usefulness and safety of a self-expanding nitinol stent (Enterprise) in the treatment of wide-necked intracranial aneurysms.
METHODS
This was a retrospective study of 39 patients with 40 wide-necked intracranial aneurysms who were enrolled in a single-center registry of patients treated with the Enterprise between June 2009 and December 2011. Thirty patients were asymptomatic, four had cerebrovascular accident sequelae, and five had suffered subarachnoid hemorrhage. One aneurysm had reopened after prior coil embolization, while 39 had not been treated. Clinical charts, procedural data, and angiographic results, including both immediate post-procedural angiograms and follow-up imaging, were reviewed.
RESULTS
The mean neck size of the aneurysms was 5.58 mm (range 3-15.1 mm). Embolization was successful in all patients. There were five procedure-related events. There were no fatalities, but one procedure-related morbidity was noted. The immediate angiographic results included eight complete occlusions (20%), six remnant necks (15%), and 26 remnant sacs (65%). At angiographic follow-up (mean: 11.3 months), out of 18 of the aneurysms treated with stent-assisted coiling, there were 13 (72.2%) complete occlusions, four (22.2%) remnant necks, and one recanalization (5.6%).
CONCLUSION
Stent-assisted coiling using the Enterprise is effective for the treatment of wide-necked intracranial aneurysms. Further angiographic and clinical follow-up investigation will be needed for evaluation of the long-term outcomes.

Keyword

Intracranial aneurysms; Coiling; Stent; Enterprise

MeSH Terms

Aneurysm*
Embolization, Therapeutic
Follow-Up Studies
Humans
Intracranial Aneurysm*
Neck
Retrospective Studies
Stents*
Stroke
Subarachnoid Hemorrhage

Figure

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  Fig. 1 An internal carotid artery aneurysm (A) originating from a posterior communicating artery, treated with the Enterprise stent system and coils (B). 3D rotational angiography shows the maximum size and neck size of the aneurysm (C). Final angiography shows a remnant sac (D). Angiography at six months reveals complete occlusion of the aneurysm (E).

• 

  Fig. 2 An internal carotid artery aneurysm (A) in a paraclinoid segment, treated with the Enterprise stent system and coils (B). 3D rotational angiography shows the maximum size and neck size of the aneurysm (C). Final angiography shows a remnant sac (D). Angiography at six months reveals complete occlusion of the aneurysm (E).

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