Endovascular Treatment of Fusiform and Wide-Necked Intracranial Aneurysms with the Neuroform 3TM and Detachable Coils

Abstract

Reconstructive treatments using stents improve occlusion rate of broad-necked intracranial aueurysms and protect parent vessels. Recently, the Neuroform stent has been developed and we evaluated it use for the treatment of fusiform and broad-necked intracranial aneurysms. Seventeen fusiform and broad-necked intracranial aneurysms in 15 patients were treated electively. Eight aneurysms were located at the internal carotid artery, five in the vertebral artery, one in the basilar tip, one in the middle cerebral artery, one in the posterior cerebellar artery and one in the posterior inferior cerebellar artery. Previous attempts with the remodeling technique had been judged technically difficult in all cases, and combined stent placement across the aneurysm neck was performed with subsequent coiling of the sac. Aneurysm diameter varied from 4 to 30 mm. Sixteen aneurysms in 15 patients were treated with this procedure. There were no stent deployment failures. All aneurysms were initially stented, followed by coil placement. Complete or subtotal (>95%) occlusion was achieved in six patients, and partial occlusion (<95%) was achieved in nine. The periprocedural rate of stroke or death was 0%. Angiographic follow-up was obtained in ten patients. Neurological status remained well in all patients at a mean clinical follow-up of 6.2±3.2 months. Primary and recurrent treatment of fusiform and wide-necked intracranial aneurysms using the Neuroform stent is feasible and effective. No permanent neurological deficits were associated with stent deployment. Short-term follow-up identified intact parent arteries and stable occlusion rates in the majority of cases.