Stent-assisted embolization of 100 middle cerebral artery aneurysms Clinical article

作者：Johnson Andrew K; Heiferman Daniel M; Lopes Demetrius K^*

来源：Journal of Neurosurgery, 2013, 118(5): 950-955.

DOI：10.3171/2013.1.JNS121298

• aneurysm
• endovascular
• middle cerebral artery
• stent
• Y-configuration stent
• vascular disorders
• interventional neurosurgery

Object. The introduction of intracranial stents to aneurysm treatment allows endovascular repair of nearly all aneurysms, but the safety and durability of stent-assisted embolization of middle cerebral artery (MCA) aneurysms is unclear. %26lt;br%26gt;Methods. Ninety-one patients with 100 complex MCA aneurysms not amenable to simple coiling were treated with stent-assisted embolization as a first option. Technical and clinical results, initial follow-up imaging, and long-term annual MR angiography (MRA) were reviewed. %26lt;br%26gt;Results. Intracranial stents were successfully deployed in all 100 aneurysms. There was 1 case of significant neurological morbidity (1%) and 1 case of death (1%) related to treatment. Initial posttreatment angiography revealed complete occlusion of 48 aneurysms (48%), a residual neck in 21(21%), and residual aneurysm filling in 31(31%). Follow-up imaging performed in 85 (90.4%) of a possible 94 aneurysms showed complete occlusion of 77 aneurysms (90.6%), residual neck in 3 (3.5%), and residual filling in 5 (5.9%). Four aneurysms (4.7%) required retreatment. Long-term MRA follow-up revealed stability or progressive thrombosis in 47 (97.9%) of 48 aneurysms. In 11 patients Y-configuration stenting caused only 1 minor complication and provided durable occlusion in all cases. %26lt;br%26gt;Conclusions. Stent-assisted techniques increase the number of aneurysms that may be treated endovascularly and represent an acceptable alternative to craniotomy. Stents provided adequate vessel reconstruction, low complication rates, and good long-term occlusion. (http://thejns.org/doi/abs/10.3171/2013.1.JNS121298)

• 出版日期2013-5