Neuroform stent-assisted embolization of incidental anterior communicating artery aneurysms: Long-term clinical and angiographic follow-up

Ahmed M. Raslan, Murat Oztaskin, Eric M. Thompson, Aclan Dogan, Bryan Petersen, Gary Nesbit, David S. Lee, Stanley L. Barnwell

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

BACKGROUND: Anterior communicating artery (A-comm) aneurysm is one of the most common intracranial aneurysms. Treatments include neurosurgical clipping or endovascular embolization. OBJECTIVE: To retrospectively examine the long-term results of Neuroform stent-assisted coil embolization of incidental A-comms, with a focus on stent-associated stenosis, long-term angiographic aneurysm occlusion outcome, delayed stent-related thromboembolus, subsequent subarachnoid hemorrhage from the treated aneurysm, and procedural complications. METHODS: Between January 7, 2003 and June 16, 2009, 44 Neuroform stents were placed as an adjunct to embolization of A-comms. Patient charts were reviewed retrospectively. Angiographic follow-up of at least 3 months (up to 6.5 years, mean 65 weeks) was available for 33 patients. Aneurysm occlusion success was determined using the Raymond classification for aneurysm remnants. RESULTS: Referencing the last angiogram in the follow-up course, complete occlusion, dog-ear residual, residual neck, and residual aneurysm were found in 24, 2, 3, and 4 patients, respectively. Stenosis (45% and asymptomatic) of the artery where the stent had been placed was found in 1 patient. One patient had delayed transient ischemic attack after dual antiplatelet therapy was stopped prematurely. Retreatment based on the presence of residual aneurysm was performed or recommended in 2 patients. In 2 patients with residual or recurrent aneurysm filling, their age or clinical condition did not warrant retreatment. CONCLUSION: Neuroform stent-assisted embolization provides long-term control of A-comms with a low incidence of aneurysm growth after treatment. The need for retreatment is uncommon, and retreatment is safe if performed. Subsequent bleeding from treated aneurysms was not observed in this study.

Original languageEnglish (US)
Pages (from-to)27-37
Number of pages11
JournalNeurosurgery
Volume69
Issue number1
DOIs
StatePublished - Jul 2011

Fingerprint

Intracranial Aneurysm
Stents
Aneurysm
Retreatment
Pathologic Constriction
Transient Ischemic Attack
Subarachnoid Hemorrhage
Ear
Angiography
Neck
Therapeutics
Arteries
Dogs
Hemorrhage
Incidence
Growth

Keywords

  • Anterior communicating artery aneurysms
  • Neuroform
  • Stent-assisted coil embolization

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Neuroform stent-assisted embolization of incidental anterior communicating artery aneurysms : Long-term clinical and angiographic follow-up. / Raslan, Ahmed M.; Oztaskin, Murat; Thompson, Eric M.; Dogan, Aclan; Petersen, Bryan; Nesbit, Gary; Lee, David S.; Barnwell, Stanley L.

In: Neurosurgery, Vol. 69, No. 1, 07.2011, p. 27-37.

Research output: Contribution to journalArticle

Raslan, Ahmed M. ; Oztaskin, Murat ; Thompson, Eric M. ; Dogan, Aclan ; Petersen, Bryan ; Nesbit, Gary ; Lee, David S. ; Barnwell, Stanley L. / Neuroform stent-assisted embolization of incidental anterior communicating artery aneurysms : Long-term clinical and angiographic follow-up. In: Neurosurgery. 2011 ; Vol. 69, No. 1. pp. 27-37.
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abstract = "BACKGROUND: Anterior communicating artery (A-comm) aneurysm is one of the most common intracranial aneurysms. Treatments include neurosurgical clipping or endovascular embolization. OBJECTIVE: To retrospectively examine the long-term results of Neuroform stent-assisted coil embolization of incidental A-comms, with a focus on stent-associated stenosis, long-term angiographic aneurysm occlusion outcome, delayed stent-related thromboembolus, subsequent subarachnoid hemorrhage from the treated aneurysm, and procedural complications. METHODS: Between January 7, 2003 and June 16, 2009, 44 Neuroform stents were placed as an adjunct to embolization of A-comms. Patient charts were reviewed retrospectively. Angiographic follow-up of at least 3 months (up to 6.5 years, mean 65 weeks) was available for 33 patients. Aneurysm occlusion success was determined using the Raymond classification for aneurysm remnants. RESULTS: Referencing the last angiogram in the follow-up course, complete occlusion, dog-ear residual, residual neck, and residual aneurysm were found in 24, 2, 3, and 4 patients, respectively. Stenosis (45{\%} and asymptomatic) of the artery where the stent had been placed was found in 1 patient. One patient had delayed transient ischemic attack after dual antiplatelet therapy was stopped prematurely. Retreatment based on the presence of residual aneurysm was performed or recommended in 2 patients. In 2 patients with residual or recurrent aneurysm filling, their age or clinical condition did not warrant retreatment. CONCLUSION: Neuroform stent-assisted embolization provides long-term control of A-comms with a low incidence of aneurysm growth after treatment. The need for retreatment is uncommon, and retreatment is safe if performed. Subsequent bleeding from treated aneurysms was not observed in this study.",
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T1 - Neuroform stent-assisted embolization of incidental anterior communicating artery aneurysms

T2 - Long-term clinical and angiographic follow-up

AU - Raslan, Ahmed M.

AU - Oztaskin, Murat

AU - Thompson, Eric M.

AU - Dogan, Aclan

AU - Petersen, Bryan

AU - Nesbit, Gary

AU - Lee, David S.

AU - Barnwell, Stanley L.

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N2 - BACKGROUND: Anterior communicating artery (A-comm) aneurysm is one of the most common intracranial aneurysms. Treatments include neurosurgical clipping or endovascular embolization. OBJECTIVE: To retrospectively examine the long-term results of Neuroform stent-assisted coil embolization of incidental A-comms, with a focus on stent-associated stenosis, long-term angiographic aneurysm occlusion outcome, delayed stent-related thromboembolus, subsequent subarachnoid hemorrhage from the treated aneurysm, and procedural complications. METHODS: Between January 7, 2003 and June 16, 2009, 44 Neuroform stents were placed as an adjunct to embolization of A-comms. Patient charts were reviewed retrospectively. Angiographic follow-up of at least 3 months (up to 6.5 years, mean 65 weeks) was available for 33 patients. Aneurysm occlusion success was determined using the Raymond classification for aneurysm remnants. RESULTS: Referencing the last angiogram in the follow-up course, complete occlusion, dog-ear residual, residual neck, and residual aneurysm were found in 24, 2, 3, and 4 patients, respectively. Stenosis (45% and asymptomatic) of the artery where the stent had been placed was found in 1 patient. One patient had delayed transient ischemic attack after dual antiplatelet therapy was stopped prematurely. Retreatment based on the presence of residual aneurysm was performed or recommended in 2 patients. In 2 patients with residual or recurrent aneurysm filling, their age or clinical condition did not warrant retreatment. CONCLUSION: Neuroform stent-assisted embolization provides long-term control of A-comms with a low incidence of aneurysm growth after treatment. The need for retreatment is uncommon, and retreatment is safe if performed. Subsequent bleeding from treated aneurysms was not observed in this study.

AB - BACKGROUND: Anterior communicating artery (A-comm) aneurysm is one of the most common intracranial aneurysms. Treatments include neurosurgical clipping or endovascular embolization. OBJECTIVE: To retrospectively examine the long-term results of Neuroform stent-assisted coil embolization of incidental A-comms, with a focus on stent-associated stenosis, long-term angiographic aneurysm occlusion outcome, delayed stent-related thromboembolus, subsequent subarachnoid hemorrhage from the treated aneurysm, and procedural complications. METHODS: Between January 7, 2003 and June 16, 2009, 44 Neuroform stents were placed as an adjunct to embolization of A-comms. Patient charts were reviewed retrospectively. Angiographic follow-up of at least 3 months (up to 6.5 years, mean 65 weeks) was available for 33 patients. Aneurysm occlusion success was determined using the Raymond classification for aneurysm remnants. RESULTS: Referencing the last angiogram in the follow-up course, complete occlusion, dog-ear residual, residual neck, and residual aneurysm were found in 24, 2, 3, and 4 patients, respectively. Stenosis (45% and asymptomatic) of the artery where the stent had been placed was found in 1 patient. One patient had delayed transient ischemic attack after dual antiplatelet therapy was stopped prematurely. Retreatment based on the presence of residual aneurysm was performed or recommended in 2 patients. In 2 patients with residual or recurrent aneurysm filling, their age or clinical condition did not warrant retreatment. CONCLUSION: Neuroform stent-assisted embolization provides long-term control of A-comms with a low incidence of aneurysm growth after treatment. The need for retreatment is uncommon, and retreatment is safe if performed. Subsequent bleeding from treated aneurysms was not observed in this study.

KW - Anterior communicating artery aneurysms

KW - Neuroform

KW - Stent-assisted coil embolization

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