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Additional Embolization for Intra-aneurysmal Blood Flow Resumption after Stent-assisted Embolization of Cerebral Aneurysms

OBJECTIVE: Stent-assisted aneurysmal embolization (SAAE) is an effective treatment for aneurysms with a low risk of recurrence. In rare cases, retreatment is necessary due to recanalization of blood flow into the aneurysm. However, only a few studies have reported on retreatment. We examined the eff...

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Autores principales: Kajiwara, Sosho, Hirohata, Masaru, Takeuchi, Yasuharu, Fujimura, Naoko, Yamashita, Shin, Nakamura, Yukihiko, Hashimoto, Aya, Morioka, Motohiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society for Neuroendovascular Therapy 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370519/
https://www.ncbi.nlm.nih.gov/pubmed/37502618
http://dx.doi.org/10.5797/jnet.oa.2019-0086
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author Kajiwara, Sosho
Hirohata, Masaru
Takeuchi, Yasuharu
Fujimura, Naoko
Yamashita, Shin
Nakamura, Yukihiko
Hashimoto, Aya
Morioka, Motohiro
author_facet Kajiwara, Sosho
Hirohata, Masaru
Takeuchi, Yasuharu
Fujimura, Naoko
Yamashita, Shin
Nakamura, Yukihiko
Hashimoto, Aya
Morioka, Motohiro
author_sort Kajiwara, Sosho
collection PubMed
description OBJECTIVE: Stent-assisted aneurysmal embolization (SAAE) is an effective treatment for aneurysms with a low risk of recurrence. In rare cases, retreatment is necessary due to recanalization of blood flow into the aneurysm. However, only a few studies have reported on retreatment. We examined the efficacy and complications of stent-assisted aneurysm embolization for large or wide-neck aneurysms at our hospital. METHODS: Between July 2010 and June 2018, 293 patients underwent stent-assisted aneurysm embolization at our hospital. Among them, 12 (2 women, 10 men, mean age: 62 years) needed retreatment. We evaluated the initial treatment of these 12 patients, and the methods and results of their retreatment. RESULTS: Six of the 12 retreated patients were treated using the simple technique. It was possible to treat nine patients (75%) without placing new stents, but three needed additional stents. We were able to guide the microcatheter into the aneurysm using the trans-cell technique even with two overlapping stents. We achieved complete embolism in seven patients (58%), and remnants were observed in the neck in five (42%) patients. No complications were associated with our surgery. We were able to perform follow-up for 10 patients and there was no recurrence. CONCLUSION: Embolization should be considered in recurrent cases after the initial stent-assisted coil embolization. We achieved good results and reduced the recurrence rate by selecting the appropriate treatment in each case.
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spelling pubmed-103705192023-07-27 Additional Embolization for Intra-aneurysmal Blood Flow Resumption after Stent-assisted Embolization of Cerebral Aneurysms Kajiwara, Sosho Hirohata, Masaru Takeuchi, Yasuharu Fujimura, Naoko Yamashita, Shin Nakamura, Yukihiko Hashimoto, Aya Morioka, Motohiro J Neuroendovasc Ther Original Article OBJECTIVE: Stent-assisted aneurysmal embolization (SAAE) is an effective treatment for aneurysms with a low risk of recurrence. In rare cases, retreatment is necessary due to recanalization of blood flow into the aneurysm. However, only a few studies have reported on retreatment. We examined the efficacy and complications of stent-assisted aneurysm embolization for large or wide-neck aneurysms at our hospital. METHODS: Between July 2010 and June 2018, 293 patients underwent stent-assisted aneurysm embolization at our hospital. Among them, 12 (2 women, 10 men, mean age: 62 years) needed retreatment. We evaluated the initial treatment of these 12 patients, and the methods and results of their retreatment. RESULTS: Six of the 12 retreated patients were treated using the simple technique. It was possible to treat nine patients (75%) without placing new stents, but three needed additional stents. We were able to guide the microcatheter into the aneurysm using the trans-cell technique even with two overlapping stents. We achieved complete embolism in seven patients (58%), and remnants were observed in the neck in five (42%) patients. No complications were associated with our surgery. We were able to perform follow-up for 10 patients and there was no recurrence. CONCLUSION: Embolization should be considered in recurrent cases after the initial stent-assisted coil embolization. We achieved good results and reduced the recurrence rate by selecting the appropriate treatment in each case. The Japanese Society for Neuroendovascular Therapy 2020-04-22 2020 /pmc/articles/PMC10370519/ /pubmed/37502618 http://dx.doi.org/10.5797/jnet.oa.2019-0086 Text en ©2020 The Japanese Society for Neuroendovascular Therapy https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Article
Kajiwara, Sosho
Hirohata, Masaru
Takeuchi, Yasuharu
Fujimura, Naoko
Yamashita, Shin
Nakamura, Yukihiko
Hashimoto, Aya
Morioka, Motohiro
Additional Embolization for Intra-aneurysmal Blood Flow Resumption after Stent-assisted Embolization of Cerebral Aneurysms
title Additional Embolization for Intra-aneurysmal Blood Flow Resumption after Stent-assisted Embolization of Cerebral Aneurysms
title_full Additional Embolization for Intra-aneurysmal Blood Flow Resumption after Stent-assisted Embolization of Cerebral Aneurysms
title_fullStr Additional Embolization for Intra-aneurysmal Blood Flow Resumption after Stent-assisted Embolization of Cerebral Aneurysms
title_full_unstemmed Additional Embolization for Intra-aneurysmal Blood Flow Resumption after Stent-assisted Embolization of Cerebral Aneurysms
title_short Additional Embolization for Intra-aneurysmal Blood Flow Resumption after Stent-assisted Embolization of Cerebral Aneurysms
title_sort additional embolization for intra-aneurysmal blood flow resumption after stent-assisted embolization of cerebral aneurysms
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370519/
https://www.ncbi.nlm.nih.gov/pubmed/37502618
http://dx.doi.org/10.5797/jnet.oa.2019-0086
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