Abstract No. 173: The Willis stent grafts placement in the treatment of intracranial aneurysm: a prospective, non-randomized multicentre trial with extremely long-term follow-up

Abstract

Purpose: For the treatment of fusiform and wide-neck intracranial aneurysms, flow-diverting stents such as the pipeline embolization device (PED; ev3, Irvine, California) were developed. This type of stent is designed to divert the flow in the parent artery, hereby reducing inflow in the aneurysm causing thrombosis. We present a series of patients with follow-up up to 1 year after pipeline stent placement. Materials and Methods: We retrospectively identified all cerebral aneurysm patients treated at the University Medical Center Utrecht with a flow diverting pipeline stent who had imaging follow up before September 2011. We collected data on age, aneurysm type and location, treatment indication and occurrence of procedural complications. On the follow up imaging data we evaluated the patency of the stent and residual filling of the aneurysm. From clinical follow up and imaging we evaluated the occurrence of ischemia. Results: 12 patients (age 20-68; average age 50) had a total of 13 aneurysms (4 previously ruptured, 2 dissecting, 5 asymptomatic and 2 symptomatic aneurysms; 3 internal carotid artery, 4 verterbral artery, 4 basilary artery, 1 PICA, and 1 proximal middle cerebral artery). In case of previous rupture, treatment with the PED was performed between 47 and 270 days after initial aneurysm coiling. No procedural complications were reported. Stent patency and post procedural aneurysm filling was evaluated at an average of 130 days (range 36-183) after treatment. No residual filling of the aneurysm and one temporary stent occlusion were reported. One patient (7%) developed ischemia in the flow territory of the treated artery (vertebral artery stent with ischemia in the pons and cerebellum). Conclusion: Treatment with the PED in our hospital shows good results with no residual filling or permanent stent occlusion. One patient developed ischemia in the flow territory of the treated vessel.