Rescue Stenting Using Neuroform Atlas Stent During Coiling Protrusion for Ruptured Intracranial Aneurysms

被引:4
作者
Semeraro, Vittorio [1 ]
Ganimede, Maria Porzia [1 ]
Lucarelli, Nicola Maria [1 ]
Lozupone, Emilio [2 ]
Vidali, Sofia [3 ]
Gisone, Vito [1 ]
Burdi, Nicola [1 ]
机构
[1] SS Annunziata Hosp, Dept Diagnost Imaging & Radiat Therapy, Taranto, Italy
[2] Univ Hosp Policlin A Gemelli IRCCS, Dept Diagnost Imaging Oncol Radiat Therapy & Hema, Rome, Italy
[3] Univ Hosp Policlin Tor Vergata, Dept Diagnost Imaging Mol Imaging Intervent Radio, Rome, Italy
关键词
Brain ruptured aneurysms; Complications management; Endovascular treatment; Hemorrhagic stroke; Interventional neuroradiology; GUGLIELMI DETACHABLE COIL; WIDE-NECKED ANEURYSMS; ENDOVASCULAR TREATMENT; EMBOLIZATION; PLACEMENT; EXPERIENCE; HERNIATION; DEPLOYMENT; RETRIEVAL; OUTCOMES;
D O I
10.1016/j.wneu.2019.04.176
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND: Endovascular coiling is generally considered as an effective treatment option for ruptured intracranial aneurysms. Increasing operator experience and quality of tools determined an improvement of endovascular cerebral aneurysms' treatment. However, procedure-related complications still occur. The purpose of this study is to report a series of rescue stenting procedures with the Neuroform Atlas (NA) opencell stent, for intraprocedural complications during coil embolization in patients with ruptured intracranial aneurysms. METHODS: Between April 2016 and January 2018, 12 consecutive coil protrusions that occurred during ruptured aneurysms' embolizations were rescued using NA stenting together with tirofiban therapy. Follow-up was performed with initial magnetic resonance angiography (MRA) at 1 month and then MRA plus standard digital subtraction angiography at 11-13 months after the procedure. RESULTS: Technical success was achieved in 100% of patients. No NA stent delivery/deployment complication occurred. Initial MRA showed complete occlusion of the aneurysm, with evidence of blood flow into parent vessels in 12 out of 12 cases. At 11-13 months, MRA and digital subtraction angiography showed 10 complete occlusion cases and 1 partial occlusion case. At 2 months, 1 death occurred due to subarachnoid hemorrhage. CONCLUSIONS: The open-cell NA stent represents a rescue option for coil protrusion during endovascular treatment of ruptured intracranial aneurysms allowing regular restoration of blood flow and minimizing thromboembolic events.
引用
收藏
页码:E454 / E460
页数:7
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