Horizontal stent-assisted coil embolisation of wide-necked intracranial aneurysms with the Enterprise stent—a case series with early angiographic follow-up

• Published in: Neuroradiology Vol. 51; no. 6; pp. 411 - 418
• Main Authors: Siddiqui, Mohammed Aslam, J. Bhattacharya, Joti, W. Lindsay, Kenneth, Jenkins, Sarah
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.06.2009; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Aneurysms; Biological and medical sciences; Blood clots; Blood Vessel Prosthesis; Brain; Cerebral Angiography; Clinical outcomes; Embolization, Therapeutic - instrumentation; Equipment Failure Analysis; Female; Humans; Imaging; Interventional Neuroradiology; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - surgery; Investigative techniques, diagnostic techniques (general aspects); Longitudinal Studies; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Miscellaneous. Technology; Nervous system; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Prosthesis Design; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiology; Retrospective Studies; Stents; Surgical techniques; Treatment Outcome; Enterprise; Horizontal; Circle of Willis; Stent; Aneurysm; Intracranial; Nervous system diseases; Angiography; Radiodiagnosis; Cardiovascular disease; Coil; Vascular disease; Neck
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-009-0517-8

Introduction The purpose of the study is to describe our experience in eight cases of horizontal stenting across the circle of Willis in patients with terminal aneurysms. Methods Eight patients were treated with horizontal stent placement and aneurysm coiling. All aneurysms had highly unfavourable dome to neck ratios. All patients were followed up with digital subtraction angiography at 3–12 months following treatment. Results The Enterprise stent was successfully deployed horizontally in vessels of less than 2-mm diameter with no stent occlusion. Neurological complications occurred in one patient. Immediate and follow-up angiographic results were encouraging with six stable occlusions at 6 months. There was one asymptomatic case of in-stent stenosis and one case of late organised in-stent thrombus. Conclusions Horizontal deployment of the Enterprise stent to assist coil embolisation of wide-necked terminal aneurysms is feasible. This device can be navigated via relatively small communicating arteries, in cases with favourable anatomy. Early angiographic results were favourable; however, longer-term follow-up will be required.