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Sole stenting of large and giant intracranial aneurysms with self-expanding intracranial stents—limits and complications

  • Clinical Article
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Abstract

Background

Intracranial aneurysms may be difficult for endovascular treatment due to size, fusiform shape, or wide neck. In such patients, intracranial stents are used to support the coils in the aneurysm sac, or they may be used as a sole stenting technique to divert the blood flow without coils. The aim of this paper is to contribute to the existing data by reviewing the risks of sole stenting of large and giant aneurysms.

Methods

We treated seven patients with nine aneurysms by self-expanding intracranial stents, either by a single or multiple stents in a stent-in-stent configuration. The follow-up was performed by digital subtraction angiography with a mean follow-up time of 6 months.

Results

A positive response to stenting ocurred in five out of seven patients (71%) and six out of nine aneurysms (67%). The aneurysms were occluded in two patients, and incomplete results were noted in three patients. The symptoms due to the compression of cranial nerves resolved in four patients (57%). Procedure-related subarachnoid hemorrhage occurred in two out of seven patients (29%), with death of one patient as a result of hemorrhage (14%).

Conclusions

Sole stenting of large and giant aneurysms with self-expanding intracranial stents may be associated with a higher risk than previously reported. The effect of stenting on intraaneurysmal flow in such aneurysms, even after the placement of multiple overlapping stents, seems to be unpredictable.

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Acknowledgements

We thank Marko Kralik, M.D. for his help in the technical preparation of the manuscript.

The authors declare to have no conflict of interest.

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Authors and Affiliations

  1. Clinical Institute of Diagnostic and Interventional Radiology, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia

    Goran Pavlisa, David Ozretic & Marko Rados

  2. Clinic of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia

    Tamara Murselovic

  3. Special Hospital for Pulmonary Diseases, Rockefellerova 3, 10000, Zagreb, Croatia

    Gordana Pavlisa

Authors
  1. Goran Pavlisa
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  2. David Ozretic
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  3. Tamara Murselovic
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  4. Gordana Pavlisa
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Correspondence to Goran Pavlisa.

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Pavlisa, G., Ozretic, D., Murselovic, T. et al. Sole stenting of large and giant intracranial aneurysms with self-expanding intracranial stents—limits and complications. Acta Neurochir 152, 763–769 (2010). https://doi.org/10.1007/s00701-009-0592-y

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  • DOI: https://doi.org/10.1007/s00701-009-0592-y

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