Solitaire AB stent‑assisted coiling embolization for the treatment of ruptured very small intracranial aneurysms

Zhang,Jifang; Wang,Donghai; Li,Xingang

doi:10.3892/etm.2015.2826

December-2015 Volume 10 Issue 6

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December-2015 Volume 10 Issue 6

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Article

Solitaire AB stent‑assisted coiling embolization for the treatment of ruptured very small intracranial aneurysms

Authors:
- Jifang Zhang
- Donghai Wang
- Xingang Li
View Affiliations / Copyright

Affiliations: Department of Neurosurgery, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China
Pages: 2239-2244
|
Published online on: October 23, 2015

https://doi.org/10.3892/etm.2015.2826
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Abstract

Recent advances in neuroradiological techniques have increasingly improved the diagnosis rate for very small aneurysms, particularly with the widespread use of three‑dimensional cerebral angiography. However, the treatment of very small aneurysms remains a considerable challenge for neurosurgeons. Endovascular coiling has emerged as a potential treatment option for intracranial aneurysms. The aim of the present study was to evaluate the safety and efficacy of Solitaire AB stent‑assisted coiling embolization for the treatment of ruptured very small intracranial aneurysms. This retrospective study included nine consecutive patients with ruptured very small intracranial aneurysms (≤3 mm) that underwent Solitaire AB stent‑assisted coiling embolization. The aneurysms were located in the ophthalmic branch of the internal carotid artery (n=2), the posterior communicating branch of the internal carotid artery (n=4), the top of the basilar artery (n=1) and the middle cerebral artery (n=2). Solitaire AB stents were successfully implanted in all nine patients. Of the nice individuals, six patients exhibited complete occlusion at Raymond grade I and three patients exhibited occlusion at Raymond grade II. No aneurysm rupture was observed during the surgery. During the follow‑up period of 8‑13 months, no intracranial hemorrhage occurred. A total of seven patients underwent follow‑up digital subtraction angiography at 5‑10 months post‑intervention. No recurrence of the aneurysms and no stenosis or occlusion of the parent arteries was observed. Therefore, Solitaire AB stent‑assisted coil embolization was demonstrated to be a safe and effective treatment for ruptured very small intracranial aneurysms. The long‑term efficacy of this technique may be improved by increasing the packing density around the aneurysmal neck and improving the hemodynamics.

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1	Zhang HQ: Is it necessary to treat the mini unruptured intracranial aneurysms? Chin J Cerebrovasc Dis. 10:1–3. 2013.
2	van Rooij WJ, Sprengers ME, de Gast AN, Peluso JP and Sluzewski M: 3D rotational angiography: The new gold standard in the detection of additional intracranial aneurysms. AJNR Am J Neuroradiol. 29:976–979. 2008. View Article : Google Scholar : PubMed/NCBI
3	Gross BA and Frerichs KU: Stent usage in the treatment of intracranial aneurysms: Past, present and future. J Neurol Neurosurg Psychiatry. 84:244–253. 2013. View Article : Google Scholar : PubMed/NCBI
4	Almekhlafi MA, Hockley A, Wong JH and Goyal M: Temporary Solitaire stent neck remodeling in the coiling of ruptured aneurysms. J Neurointerv Surg. 5(Suppl 3): iii76–iii78. 2013.PubMed/NCBI
5	Gory B, Klisch J, Bonafé A, et al: Solitaire AB stent-assisted coiling of wide-necked intracranial aneurysms: Short-term results from a prospective, consecutive, European multicentric study. Neuroradiology. 55:1373–1378. 2013. View Article : Google Scholar : PubMed/NCBI
6	Clajus C, Sychra V, Strasilla C and Klisch J: Stent-assisted coil embolization of intracranial aneurysms using the Solitaire™ AB Neurovascular Remodeling Device: Initial and midterm follow-up results. Neuroradiology. 55:629–638. 2013. View Article : Google Scholar : PubMed/NCBI
7	Zhao KJ, Zhang YW, Xu Y, et al: Reconstruction of saccular and dissected intracranial aneurysms using Solitaire™ AB stents. PLoS One. 8:e572532013. View Article : Google Scholar : PubMed/NCBI
8	Roy D, Milot G and Raymond J: Endovascular treatment of unruptured aneurysms. Stroke. 32:1998–2004. 2001. View Article : Google Scholar : PubMed/NCBI
9	Bonita R and Beaglehole R: Recovery of motor function after stroke. Stroke. 19:1497–1500. 1988. View Article : Google Scholar : PubMed/NCBI
10	Hong B, Yang PF, Zhao R, et al: Endovascular treatment of ruptured tiny intracranial aneurysms. J Clin Neurosci. 18:655–660. 2011. View Article : Google Scholar : PubMed/NCBI
11	Gupta V, Chugh M, Jha AN, Walia BS and Vaishya S: Coil embolization of very small (2 mm or smaller) berry aneurysms: Feasibility and technical issues. AJNR Am J Neuroradiol. 30:308–314. 2009. View Article : Google Scholar : PubMed/NCBI
12	Brinjikji W, Lanzino G, Cloft HJ, Rabinstein A and Kallmes DF: Endovascular treatment of very small (3 mm or smaller) intracranial aneurysms: Report of a consecutive series and a meta-analysis. Stroke. 41:116–121. 2010. View Article : Google Scholar : PubMed/NCBI
13	Lu J, Liu JC, Wang LJ, Qi P and Wang DM: Tiny intracranial aneurysms: Endovascular treatment by coil embolisation or sole stent deployment. Eur J Radiol. 81:1276–1281. 2012. View Article : Google Scholar : PubMed/NCBI
14	Fang C, Li MH, Zhu YQ, et al: The effectiveness and feasibility of endovascular coil embolization for very small cerebral aneurysms: mid- and long-term follow-up. Ann Vasc Surg. 24:400–407. 2010. View Article : Google Scholar : PubMed/NCBI
15	Im SH, Han MH, Kwon OK, et al: Endovascular coil embolization of 435 small asymptomatic unruptured intracranial aneurysms: Procedural morbidity and patient outcome. AJNR Am J Neuroradiol. 30:79–84. 2009. View Article : Google Scholar : PubMed/NCBI
16	Zhou C, Hong QH, Zhao R, Xu Y, Hong B and Zhao WY: Stent-assisted coil embolization of ruptured anterior communicating artery tiny aneurysms. Chin J Cerebrovasc Dis. 10:9–12. 2013.
17	Martínez-Galdámez M, Saura P, Saura J, Martínez A, De Campos JM and Pérez A: Y-stent-assisted coil embolization of anterior circulation aneurysms using two Solitaire AB devices: A single center experience. Interv Neuroradiol. 18:158–163. 2012.PubMed/NCBI
18	Sychra V, Klisch J, Werner M, et al: Waffle-cone technique with Solitaire™ AB remodeling device: Endovascular treatment of highly selected complex cerebral aneurysms. Neuroradiology. 53:961–972. 2011. View Article : Google Scholar : PubMed/NCBI
19	Klisch J, Clajus C, Sychra V, et al: Coil embolization of anterior circulation aneurysms supported by the Solitaire AB Neurovascular Remodeling Device. Neuroradiology. 52:349–359. 2010. View Article : Google Scholar : PubMed/NCBI