Covered Stent Placement for Artificial Cervical Carotid Aneurysms

Abstract

In order to evaluate the midterm patency and the effectiveness of Dacron-covered self-expanding metallic stent in the treatment of cervical carotid aneurysm, we made wide-necked carotid aneurysms with a technique of vein pouch end-to-side anastomosis, and implanted the stents percutaneously to occlude the aneurysms in dogs. The patency was angiographically followed up for 3 months with anticoagulation and antiplatelet medications. The Dacron-covered stent could make the aneurysms disappear angiographically within ten minutes if it was implanted in the correct place. The acute thrombotic obstruction was seen in one of the five regions. The delayed stenosis was seen in two of the five regions in two weeks. Only one of the five regions was patent three months after the stent placement without stenosis. In this case, no cerebral infarction of the brain was found histologically. The Dacron-covered stent can make wide-necked aneurysms occlude quickly. However, the short or midterm patency was poor, suggesting that it is not safe enough to be used clinically in carotid lesions. Further study should be needed to improve the materials for a covered stent before clinical applications.