Embolization of multiple wide-necked intracranial aneurysms assisted with single Solitaire stent

Abstract

Objective To investigate the technical methods of embolization of multiple wide-necked intracranial aneurysms on the same artery by using single Solitaire stent assistance in order to provide the clinical support for the minimally invasive treatment of intracranial multiple wide-necked aneurysms. Methods In patients with multiple aneurysm on a single parent artery, 15 patients with wide-necked aneurysms admitted to the Department of Neurosurgery, Qilu Hospital of Shandong University and the Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region from June 2011 to February 2014. Seldinger technique was used for the placement of needle sheaths in femoral artery, the different specifications of Solitaire stents were selected according to the aneurysm neck, distance between the two aneurysms, and the diameter of parent artery. Using the methods of preset stent catheters and embolizing micro-catheters, a single stent covered 2 wide-necked aneurysms on the same parent artery. Microcoils were used to embolize the aneurysms under the assistance of stents. Results A total of 15 patients with wide-necked intracranial aneurysms in this group, including 8 in anterior circulation and 7 in posterior circulation. Stent implantation was satisfactory in all patients during the procedure. The aneurysms of 11 patients were embolized completely, 3 had a little residue on aneurysm necks, a part of microcoil in 1 case escaped from a stent during the procedure, 1 occurred thrombosis during the procedure and it was recanalized immediately after thrombolytic treatment. The patients were followed up after 6 months, 12 performed head CTA or DSA examinations, 2 relapsed on the neck, and 1 was reembolized. Conclusion Using single Solitaire stent-assisted microcoil embolization of the multiple wide-necked intracranial aneurysms in the same parent artery has the advantages of minimally invasive, easy to operate, and curative effect. It provides an effective option for the minimally invasive treatment of multiple intracranial wide-necked aneurysms. Key words: Intracranial aneurysm; Endovascular treatment; Stent; Coil