J Korean Soc Radiol.  2014 Mar;70(3):181-190. 10.3348/jksr.2014.70.3.181.

Comparison of Enterprise and Neuroform Stent-Assisted Coil Embolization of Distal Internal Carotid Artery Aneurysms: Midterm Results from a Single-Center Experience

• Choi WJ
• Baik SK
• Yeom JA
• Kim YS
• Lee SW

• KMID: 1839429
• DOI: http://doi.org/10.3348/jksr.2014.70.3.181

Abstract

PURPOSE
To compare the mid-term follow-up angiographic findings in distal internal carotid artery (ICA) aneurysms treated by stent-assisted coil embolization using the Enterprise or Neuroform stent.
MATERIALS AND METHODS
We included 68 patients with 70 aneurysms: 31 cases with Enterprise and 39 cases with Neuroform. Inclusion criteria were 1) location of the stent within the distal ICA, including the carotid siphon; 2) follow-up angiogram after > 6 months, and 3) single use of the stent for 1 parent artery.
RESULTS
The patients' mean age was 54.9 years (16 male and 52 female). Mean follow-up duration was 9.1 months. At follow-up, there were intraluminal filling defects of the parent artery in 19.4% of the Enterprise group and no filling defect in the Neuroform group. There was no significant in-stent stenosis in either group. Straightening of the parent artery was seen in 35.5% of the Enterprise group and 20.5% of the Neuroform group. Two Enterprise cases showed delayed migration.
CONCLUSION
The Enterprise showed statistically significant intraluminal filling defects of the parent artery compared with the Neuroform. The rates of significant in-stent stenosis and straightening of the parent artery were not significantly different between the Enterprise and the Neuroform groups.

MeSH Terms

Aneurysm*
Arteries
Carotid Artery, Internal*
Constriction, Pathologic
Embolization, Therapeutic*
Follow-Up Studies
Humans
Intracranial Aneurysm
Male
Parents
Stents

Figure

• 

  Fig. 1 Intraluminal filling defect (incomplete stent apposition). A. A 67-year-old woman has a left P-com aneurysm (arrowhead) and two right paraclinoid aneurysms (arrow and open arrow). Immediate post-procedural angiography shows right paraclinoid ICA aneurysm after stent-assisted coiling using a 4.5 × 28 mm Enterprise stent with complete occlusion and a just proximal paraclinoid aneurysm treated by stent only. B. Eight-month follow-up angiography reveals an intraluminal filling defect (arrow) at the substented area of the siphon (between proximal arrowhead and distal arrowhead). Note.-ICA = internal carotid artery

• 

  Fig. 2 In-stent stenosis. A 64-year-old woman with an incidentally found aneurysm. A. Immediate post-procedural angiography shows left paraclinoid ICA aneurysm after stent-assisted coiling using a 4.5 × 20 mm Neuroform stent. Subtle contrast filling of the aneurysm sac is seen. B. Six-month follow-up angiography shows that the aneurysm underwent progressive occlusion as there is no residual flow visible. In addition, there is mild (40%) narrowing of substented area of the parent artery. But it is not significant in-stent stenosis, according to our definition: we defined the term "significant in-stent stenosis" as more than 50% narrowing within the stent-deployment area of the parent artery. Note.-ICA = internal carotid artery

• 

  Fig. 3 Parent artery straightening. A 36-year-old woman presented with severe headache. Examination revealed subarachnoid hemorrhage due to ruptured aneurysm. A. Immediate post-procedural angiography shows a right paraclinoid ICA aneurysm after stent-assisted coiling using a 4.5 × 28 mm Enterprise stent with complete occlusion. B. Twelve-month follow-up angiography reveals increased vascular curvature of the carotid siphon ("straightening") and focal intraluminal filling defect at the substented area (arrow). Note.-ICA = internal carotid artery

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