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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

Hemorrhage after stenting in one patient.(a–b) Figure depicts a 65-year-old man with a left MCA ruptured wide-necked aneurysm (2.5 mm × 3.2 mm) (white arrow). (c–e) Solitaire AB stent (4 mm × 20 mm) (white arrow) assisting complete occlusion; there was parent artery patency. (f) CT revealing hemorrhage in the left MCA area 5 h after surgery.
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pone.0139714.g002: Hemorrhage after stenting in one patient.(a–b) Figure depicts a 65-year-old man with a left MCA ruptured wide-necked aneurysm (2.5 mm × 3.2 mm) (white arrow). (c–e) Solitaire AB stent (4 mm × 20 mm) (white arrow) assisting complete occlusion; there was parent artery patency. (f) CT revealing hemorrhage in the left MCA area 5 h after surgery.

Mentions: Eight patients had perioperative complications (6.9%, 8/116). Among them, four were hemorrhagic: there were three cases of perioperative aneurysm rupture, which were resolved by the insertion of more coils; computed tomography (CT) scan immediately after the procedure revealed a small amount of subarachnoid hemorrhage, and the patients only suffered a mild headache. Aneurysm rerupture was detected in the fourth patient, who died from herniation after surgery because his family refused craniotomy. This patient had vomited and had gone into a coma 5 h after stenting; CT revealed intracerebral hemorrhage around the stent, and the patient died 2 h after that because of cerebral hernia (Fig 2A–2F).


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)

Hemorrhage after stenting in one patient.(a–b) Figure depicts a 65-year-old man with a left MCA ruptured wide-necked aneurysm (2.5 mm × 3.2 mm) (white arrow). (c–e) Solitaire AB stent (4 mm × 20 mm) (white arrow) assisting complete occlusion; there was parent artery patency. (f) CT revealing hemorrhage in the left MCA area 5 h after surgery.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0139714.g002: Hemorrhage after stenting in one patient.(a–b) Figure depicts a 65-year-old man with a left MCA ruptured wide-necked aneurysm (2.5 mm × 3.2 mm) (white arrow). (c–e) Solitaire AB stent (4 mm × 20 mm) (white arrow) assisting complete occlusion; there was parent artery patency. (f) CT revealing hemorrhage in the left MCA area 5 h after surgery.
Mentions: Eight patients had perioperative complications (6.9%, 8/116). Among them, four were hemorrhagic: there were three cases of perioperative aneurysm rupture, which were resolved by the insertion of more coils; computed tomography (CT) scan immediately after the procedure revealed a small amount of subarachnoid hemorrhage, and the patients only suffered a mild headache. Aneurysm rerupture was detected in the fourth patient, who died from herniation after surgery because his family refused craniotomy. This patient had vomited and had gone into a coma 5 h after stenting; CT revealed intracerebral hemorrhage around the stent, and the patient died 2 h after that because of cerebral hernia (Fig 2A–2F).

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