Progressive occlusion of aneurysms in Neuroform Stent-assisted treatment of intracranial aneurysms

被引:14
作者
Yahia, A. M. [1 ,2 ,3 ]
Latorre, J. G. [1 ]
Gordon, V. [5 ]
Whapham, J. [6 ]
Swarnkar, A. [3 ]
Fessler, R. D. [4 ,5 ]
机构
[1] Upstate Med Univ, Dept Neurol, Syracuse, NY 13210 USA
[2] Upstate Med Univ, Dept Neurosurg, Syracuse, NY 13210 USA
[3] Upstate Med Univ, Dept Radiol, Syracuse, NY 13210 USA
[4] Wayne State Univ, Dept Neurosurg, Detroit, MI USA
[5] Providence Main Hosp St John Hlth, Dept Neurosurg, Detroit, MI USA
[6] Loyola Univ, Dept Neurosurg, Sch Med, Chicago, IL USA
关键词
CEREBRAL ANEURYSMS; BALLOON INJURY; FOLLOW-UP; EXPERIENCE;
D O I
10.1136/jnnp.2009.173864
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction The long term effect of Neuroform stent in progressive occlusion of intracranial aneurysms is not yet completely understood. Here the effect of the Neuroform stent in progressive occlusion of intracranial aneurysms and clinical outcome is reported. Methods Consecutive patients treated with the Neuroform stent from January 2003 to July 2007 were prospectively enrolled. Patients' demographics, immediate and delayed rate of occlusion, and clinical outcomes using the National Institution of Health Stroke Scale (NIHSS) and the Glasgow Outcome Scale (GOS) were recorded. Results Neuroform stent placement was attempted in 72 patients, including 10 ruptured cases. However, stent placement could not be accomplished in two patients who were not included for analysis. Mean age was 50 +/- 14 years and mean aneurysm diameter was 10.2 +/- 65.9 mm. Immediate complete occlusion was observed in 31 (44%), neck remnants in 29 (41%) and subtotal occlusion in 10 (14%). Angiographic follow-up was available in 59 cases; complete occlusion was observed in 48/59 (81%), neck remnant in 7/59 (13%) and recanalisation in 4/49 (7%). Of 39 patients with immediate incomplete obliteration, progressive complete occlusions were achieved in 25/31 (81%), no changes in two and recanalisation in four cases. The majority of patients had good outcomes (GOS 1 or NIHSS 0 in 66/70 (94%), GOS 2 or NIHSS 2 in one patient and GOS 3 or NIHSS 4 in three at the 90 day follow-up visit. Conclusions The Neuroform stent assisted neck remodelling technique improves progressive obliteration of intracranial aneurysms with a low recanalisation rate and good clinical outcome.
引用
收藏
页码:278 / 282
页数:5
相关论文
共 13 条
[1]   Cyclic GMP-dependent protein kinase expression in coronary arterial smooth muscle in response to balloon catheter injury [J].
Anderson, PG ;
Boerth, NJ ;
Liu, M ;
McNamara, DB ;
Cornwell, TL ;
Lincoln, TM .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2000, 20 (10) :2192-2197
[2]   Endovascular occlusion of wide-necked aneurysms with a new intracranial microstent (neuroform) and detachable coils [J].
Benitez, RP ;
Silva, MT ;
Klem, J ;
Veznedaroglu, E ;
Rosenwasser, RH .
NEUROSURGERY, 2004, 54 (06) :1359-1367
[3]   Neuroform stent-assisted coil embolization of wide-neck intracranial aneurysms: Strategies in stent deployment and midterm follow-up [J].
Biondi, Alessandra ;
Janardhan, Vallabh ;
Katz, Jeffrey M. ;
Salvaggio, Kimberly ;
Riina, Howard A. ;
Gobin, Y. Pierre .
NEUROSURGERY, 2007, 61 (03) :460-468
[4]   Usefulness of the neuroform stent for the treatment of cerebral aneurysms: Results at initial (3-6-mo) follow-up [J].
Fiorella, D ;
Albuquerque, FC ;
Deshmukh, VR ;
McDougall, CG .
NEUROSURGERY, 2005, 56 (06) :1191-1201
[5]   Preliminary experience using the neuroform stent for the treatment of cerebral aneurysms [J].
Fiorella, D ;
Albuquerque, FC ;
Han, P ;
McDougall, CG .
NEUROSURGERY, 2004, 54 (01) :6-16
[6]   The neuroform stent, the first microcatheter-delivered stent for use in the intracranial circulation [J].
Howington, JU ;
Hanel, RA ;
Harrigan, MR ;
Levy, EI ;
Guterman, LR ;
Hopkins, LN .
NEUROSURGERY, 2004, 54 (01) :2-5
[7]  
Jabbour Pascal, 2004, Neurosurg Focus, V17, pE10
[8]   Staged stent-assisted angioplasty for symptomatic intracranial vertebrobasilar artery stenosis [J].
Levy, EI ;
Hanel, RA ;
Bendok, BR ;
Boulos, AS ;
Hartney, ML ;
Guterman, LR ;
Qureshi, AI ;
Hopkins, LN .
JOURNAL OF NEUROSURGERY, 2002, 97 (06) :1294-1301
[9]   SUSTAINED ACTIVATION OF VASCULAR CELLS AND LEUKOCYTES IN THE RABBIT AORTA AFTER BALLOON INJURY [J].
TANAKA, H ;
SUKHOVA, GK ;
SWANSON, SJ ;
CLINTON, SK ;
GANZ, P ;
CYBULSKY, MI ;
LIBBY, P .
CIRCULATION, 1993, 88 (04) :1788-1803
[10]   Inflammation as a key event in the development of neointima following vascular balloon injury [J].
Wainwright, CL ;
Miller, AM ;
Wadsworth, RM .
CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, 2001, 28 (11) :891-895