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Does a Low-wall Coverage Stent Have a Flow Diverting Effect in Small Aneurysms?

BACKBROUND AND PURPOSE: The flow diverting effect of a low-wall coverage stent remains controversial. We evaluted patients who underwent stenting for small aneurysms with a low but potential risk of growth and reviewed related literature. MATERIALS AND METHODS: We evaluated 9 small aneurysms among 1...

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Detalles Bibliográficos
Autores principales: Liu, Hairi, Choe, Jooae, Jung, Seung Chul, Song, Yunsun, Yang, Ku Hyun, Park, Kye Jin, Goo, Hae Won, Park, Won Hyong, Suh, Dae Chul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Interventional Neuroradiology 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4571559/
https://www.ncbi.nlm.nih.gov/pubmed/26389012
http://dx.doi.org/10.5469/neuroint.2015.10.2.89
Descripción
Sumario:BACKBROUND AND PURPOSE: The flow diverting effect of a low-wall coverage stent remains controversial. We evaluted patients who underwent stenting for small aneurysms with a low but potential risk of growth and reviewed related literature. MATERIALS AND METHODS: We evaluated 9 small aneurysms among 19 unruptured intracranial aneurysms from eight patients who underwent stenting. The patients had unexplainable severe headache (n = 8), aneurysm originating from the anterior choroidal artery (n = 3), potential growth or rupture risks including hypertension (n = 5), and multiple aneurysms (n = 6). Stents with a relatively low-wall coverage ratio (8-10%) were used. Clinical and angiographic outcomes were assessed. RESULTS: One (n = 8) or two stents (n = 1) were used without any procedural difficulties or complications. Although no immediate changes of aneurysm morphology were observed, aneurysms decreased in size (n = 8) when examined by DSA (n = 8) or MRA (n = 1) during a median 28.9-month follow-up. There were no adverse events, including thromboembolism, aneurysm rupture, or stent movement during a median 31.9-month clinical follow-up (range: 17-69 months). CONCLUSION: Although a variable degree of aneurysm size decrease may not prevent further growth or rupture of small aneurysms, stenting with a low-wall coverage ratio may have some advantageous hemodynamic effect. Flow modification of stent architecture vs. aneurysm characteristics, including size and location, on long-term outcome, requires further clarification.