Abstract
MCA aneurysms are common and often pose technical challenges to interventionalists. Intracranial stents are widely used in treating wide-neck aneurysms in other locations. To evaluate the feasibility, effectiveness, and safety of stent placement in MCA aneurysms, we performed this retrospective study. Between October 2003 and May 2009, 16 patients with 16 wide-neck MCA aneurysms were treated with stents at our institution. We retrospectively collected and analyzed the data for these patients, including demographics, morphologic features of the aneurysms, treatment results, and follow-up. Seventeen stents, including 12 Neuroform, 4 LEO, and 1 Enterprise, were successfully deployed in this series. Of the 13 aneurysms treated with stent-assisted embolization, complete occlusion was achieved in 9 aneurysms; residual neck remained in 1, and residual aneurysm was present in 3. Contrast stasis in the aneurysm sac was observed in the other 3 aneurysms treated with stent alone. Procedure-related complication occurred in 1 patient, leading to no permanent effect. The mRS score at discharge was 0-2 in 14 patients and 3-6 in 2. The angiographic follow-up results of 9 patients (mean, 5.6 months) showed that all aneurysms remained stable or improved; there was no in-stent stenosis, recurrence, or retreatment. The clinical follow-up (mean, 20.1 months) demonstrated no neurologic deterioration or rebleeding. Our preliminary experience demonstrates that stent placement for the treatment of selected wide-neck MCA aneurysms is feasible. However, its safety and efficacy should be further evaluated by larger case series and more adequate follow-up.
Highlights
AND PURPOSE: MCA aneurysms are common and often pose technical challenges to interventionalists
Our preliminary experience demonstrates that stent placement for the treatment of selected wide-neck MCA aneurysms is feasible
Surgical clipping is preferred over endovascular embolization for the treatment of MCA aneurysms,2-4 mainly because MCA aneurysms are proximal to the cerebral surface and require less brain retraction to access and expose them
Summary
Between October 2003 and May 2009, 16 patients with 16 wide-neck MCA aneurysms were treated with stents at our institution. Patient Population During the past 67 months, from October 2003 to April 2009, 73 patients harboring 73 MCA aneurysms presented to our institution. Of these patients, 16 (7 women, 9 men) with 16 wide-neck MCA aneurysms were treated by either stent-assisted coiling or stent placement alone; they ranged from 39 to 69 years of age (mean age, 49.7 years). Aneurysm Morphology Of the 16 wide-neck MCA aneurysms, 2 were located at the M1 segment, and 14, at the MCA bifurcation.
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