Department of Radiology; New England Center for Stroke Research
Nervous System Diseases | Neurology | Radiology
BACKGROUND AND PURPOSE: Recanalization is observed in 20-40% of endovascularly treated intracranial aneurysms. To further reduce the recanalization and expand endovascular treatment, we evaluated the safety and efficacy of closed-cell SACE.
MATERIALS AND METHODS: Between 2007 and 2010, 147 consecutive patients (110 women; mean age, 54 years) presenting at 2 centers with 161 wide-neck ruptured and unruptured aneurysms were treated by using SACE. Inclusion criteria were wide-neck aneurysms ( > 4 mm or a dome/neck ratio
RESULTS: Eighteen aneurysms (11%) were treated following rupture. Procedure-related mortality and permanent neurologic deficits occurred in 2 (1.4%) and 5 patients (3.4%), respectively. In total, 7 patients (4.8%) died, including 2 with reruptures. Of the 140 surviving patients, 113 (80.7%) patients with 120 aneurysms were available for follow-up neurologic examination at a mean of 11.8 months. An increase in mRS score from admission to follow-up by 1, 2, or 3 points was seen in 7 (6.9%), 1 (1%), and 2 (2%) patients, respectively. Follow-up angiography was performed in 120 aneurysms at a mean of 11.9 months. Recanalization occurred in 12 aneurysms (10%), requiring retreatment in 7 (5.8%). Moderate in-stent stenosis was seen in 1 (0.8%), which remained asymptomatic.
CONCLUSIONS: This series adds to the evidence demonstrating the safety and effectiveness of SACE in the treatment of intracranial aneurysms. However, SACE of ruptured aneurysms and premature termination of antiplatelet treatment are associated with increased morbidity and mortality.
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Open access. © 2012 by American Journal of Neuroradiology. Publisher PDF posted as allowed by the publisher's author rights policy at http://www.ajnr.org/page/content/Information-for-Authors. Citation: AJNR Am J Neuroradiol. 2012 Oct;33(9):1651-6. Epub 2012 Apr 5. Link to article on publisher's site
Wakhloo, Ajay K.; Linfante, I.; Silva, C. F.; Samaniego, E. A.; Dabus, G.; Etezadi, V.; Spilberg, Gabriela; and Gounis, Matthew J., "Closed-cell stent for coil embolization of intracranial aneurysms: clinical and angiographic results" (2012). Radiology Publications and Presentations. 296.