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The Use of Solitaire AB Stents in Coil Embolization of Wide-Necked Cerebral Aneurysms.

Li TF, Shui SF, Han XW, Yan L, Ma J, Guo D, Zhu HC, Wang SK, He YH, Chen WW, Wei LP, Wang MK, Song TM - PLoS ONE (2015)

Bottom Line: However, large sample studies on its safety and effectiveness are lacking.We also observed complications to evaluate the safety and effectiveness of this therapy.All stents were inserted successfully.

View Article: PubMed Central - PubMed

Affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Interventional Institute of Zhengzhou University, Zhengzhou, China.

ABSTRACT

Background: The Solitaire AB stent is one of many assistant stents used for treating wide-necked cerebral aneurysm, and has been used since 2003. However, large sample studies on its safety and effectiveness are lacking. The objective of this study was to evaluate the effectiveness and safety of the Solitaire AB stent in the coil embolization of wide-necked cerebral aneurysms.

Methods: Retrospective review of the clinical and image data of 116 patients with wide-necked cerebral aneurysms who had been enrolled at six interventional neuroradiology centers from February 2010 to February 2014 and had been treated by coil embolization; in total, 120 Solitaire AB stents were used. The degree of aneurysm occlusion was examined using digital subtraction angiography (DSA) immediately after the procedure and during follow-up, and was graded using the modified Raymond classification. We also observed complications to evaluate the safety and effectiveness of this therapy.

Results: The 120 Solitaire AB stents (4 mm × 15 mm, four stents; 4 mm × 20 mm, 16 stents; 6 mm × 20 mm, 36 stents; 6 mm × 30 mm, 64 stents) were inserted to treat 120 wide-necked cerebral aneurysms. All stents were inserted successfully. DSA immediately post-surgery revealed 55 cases of complete occlusion, 59 cases of neck remnant, and six cases of aneurysm remnant. Perioperatively, there were four cases of hemorrhage and four cases of stent thrombosis. The follow-up spanned 3-37 months; of 92 patients examined by DSA at the 6-month follow up, 12 had disease recurrence.

Conclusions: The Solitaire AB stent is effective with a good technical success rate and short-term effect for assisting coil embolization of wide-necked cerebral aneurysms.

No MeSH data available.


Related in: MedlinePlus

Solitaire AB stent (6 mm × 30 mm) assisting complete occlusion in one patient.(a) Figure depicts a 43-year-old woman with an unruptured aneurysm. DSA revealed a left C3 artery wide-necked aneurysm (6.5 mm × 4.2 mm) (white arrow). (b) Solitaire AB stent (6 mm × 30 mm) (white arrow) assisting embolization. DSA immediately after the procedure revealed complete occlusion of the aneurysm and parent artery patency. (c-d) DSA at the 6-month follow-up revealed no aneurysm development, and revealed parent artery patency.
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pone.0139714.g001: Solitaire AB stent (6 mm × 30 mm) assisting complete occlusion in one patient.(a) Figure depicts a 43-year-old woman with an unruptured aneurysm. DSA revealed a left C3 artery wide-necked aneurysm (6.5 mm × 4.2 mm) (white arrow). (b) Solitaire AB stent (6 mm × 30 mm) (white arrow) assisting embolization. DSA immediately after the procedure revealed complete occlusion of the aneurysm and parent artery patency. (c-d) DSA at the 6-month follow-up revealed no aneurysm development, and revealed parent artery patency.

Mentions: The 116 patients with 120 wide-necked aneurysms received 120 Solitaire AB stents (four stents, 4 mm × 15 mm; 16 stents, 4 mm × 20 mm; 36 stents, 6 mm × 20 mm; 64 stents, 6 mm × 30 mm). All stents were inserted successfully: 97 were inserted once successfully, while 23 were released twice because the coils emerged in the parent artery. Stents were Guglielmi-detached once successfully in 94 cases, twice successfully in 17 cases, and thrice successfully in 10 cases, with detachment time ranging 41–272 s (average, 107 s). DSA immediately after the procedure showed that 55 cases had complete occlusion (45.8%, 55/120) (Fig 1A–1D), 59 cases had neck remnants (49.2%, 59/120), and six had aneurysm remnants (5.0%, 6/120).


The Use of Solitaire AB Stents in Coil Embolization of Wide-Necked Cerebral Aneurysms.

Li TF, Shui SF, Han XW, Yan L, Ma J, Guo D, Zhu HC, Wang SK, He YH, Chen WW, Wei LP, Wang MK, Song TM - PLoS ONE (2015)

Solitaire AB stent (6 mm × 30 mm) assisting complete occlusion in one patient.(a) Figure depicts a 43-year-old woman with an unruptured aneurysm. DSA revealed a left C3 artery wide-necked aneurysm (6.5 mm × 4.2 mm) (white arrow). (b) Solitaire AB stent (6 mm × 30 mm) (white arrow) assisting embolization. DSA immediately after the procedure revealed complete occlusion of the aneurysm and parent artery patency. (c-d) DSA at the 6-month follow-up revealed no aneurysm development, and revealed parent artery patency.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4591355&req=5

pone.0139714.g001: Solitaire AB stent (6 mm × 30 mm) assisting complete occlusion in one patient.(a) Figure depicts a 43-year-old woman with an unruptured aneurysm. DSA revealed a left C3 artery wide-necked aneurysm (6.5 mm × 4.2 mm) (white arrow). (b) Solitaire AB stent (6 mm × 30 mm) (white arrow) assisting embolization. DSA immediately after the procedure revealed complete occlusion of the aneurysm and parent artery patency. (c-d) DSA at the 6-month follow-up revealed no aneurysm development, and revealed parent artery patency.
Mentions: The 116 patients with 120 wide-necked aneurysms received 120 Solitaire AB stents (four stents, 4 mm × 15 mm; 16 stents, 4 mm × 20 mm; 36 stents, 6 mm × 20 mm; 64 stents, 6 mm × 30 mm). All stents were inserted successfully: 97 were inserted once successfully, while 23 were released twice because the coils emerged in the parent artery. Stents were Guglielmi-detached once successfully in 94 cases, twice successfully in 17 cases, and thrice successfully in 10 cases, with detachment time ranging 41–272 s (average, 107 s). DSA immediately after the procedure showed that 55 cases had complete occlusion (45.8%, 55/120) (Fig 1A–1D), 59 cases had neck remnants (49.2%, 59/120), and six had aneurysm remnants (5.0%, 6/120).

Bottom Line: However, large sample studies on its safety and effectiveness are lacking.We also observed complications to evaluate the safety and effectiveness of this therapy.All stents were inserted successfully.

View Article: PubMed Central - PubMed

Affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Interventional Institute of Zhengzhou University, Zhengzhou, China.

ABSTRACT

Background: The Solitaire AB stent is one of many assistant stents used for treating wide-necked cerebral aneurysm, and has been used since 2003. However, large sample studies on its safety and effectiveness are lacking. The objective of this study was to evaluate the effectiveness and safety of the Solitaire AB stent in the coil embolization of wide-necked cerebral aneurysms.

Methods: Retrospective review of the clinical and image data of 116 patients with wide-necked cerebral aneurysms who had been enrolled at six interventional neuroradiology centers from February 2010 to February 2014 and had been treated by coil embolization; in total, 120 Solitaire AB stents were used. The degree of aneurysm occlusion was examined using digital subtraction angiography (DSA) immediately after the procedure and during follow-up, and was graded using the modified Raymond classification. We also observed complications to evaluate the safety and effectiveness of this therapy.

Results: The 120 Solitaire AB stents (4 mm × 15 mm, four stents; 4 mm × 20 mm, 16 stents; 6 mm × 20 mm, 36 stents; 6 mm × 30 mm, 64 stents) were inserted to treat 120 wide-necked cerebral aneurysms. All stents were inserted successfully. DSA immediately post-surgery revealed 55 cases of complete occlusion, 59 cases of neck remnant, and six cases of aneurysm remnant. Perioperatively, there were four cases of hemorrhage and four cases of stent thrombosis. The follow-up spanned 3-37 months; of 92 patients examined by DSA at the 6-month follow up, 12 had disease recurrence.

Conclusions: The Solitaire AB stent is effective with a good technical success rate and short-term effect for assisting coil embolization of wide-necked cerebral aneurysms.

No MeSH data available.


Related in: MedlinePlus