Abstract
We aimed to examine aneurysm hemodynamics with intra-saccular pressure measurement, and compare the effects of coiling, stenting and stent-assisted coiling in proximal segments of intracranial circulation. A cohort of 45 patients underwent elective endovascular coil embolization (with or without stent) for intracranial aneurysm at our department. Arterial pressure transducer was used for all measurements. It was attached to proximal end of the microcatheter. Measurements were taken in the parent artery before and after embolization, at the aneurysm dome before embolization, after stent implantation, and after embolization. Stent-assisted coiling was performed with 4 different stents: LVIS and LVIS Jr (Microvention, Tustin, CA, USA), Leo (Balt, Montmorency, France), Barrel VRD (Medtronic/ Covidien, Irvine, CA, USA). Presence of the stent showed significant reverse correlation with intra-aneurysmal pressure-both systolic and diastolic-after its implantation (r = -0.70 and r = -0.75, respectively), which was further supported by correlations with stent cell size-r = 0.72 and r = 0.71, respectively (P<0.05). Stent implantation resulted in significant decrease in diastolic intra-aneurysmal pressure (p = 0.046). Systolic or mean intra-aneurysmal pressure did not differ significantly. Embolization did not significantly change the intra-aneurysmal pressure in matched pairs, regardless of the use of stent (p>0.05). In conclusion, low-profile braided stents show a potential to divert blood flow, there was significant decrease in diastolic pressure after stent placement. Flow-diverting properties were related to stent porosity. Coiling does not significantly change the intra-aneurysmal pressure, regardless of packing density.
Highlights
Endovascular coiling has an established position in treatment of intracranial aneurysms. [1] Self-expandable stents extended the indications for endovascular therapy for wide-necked and complex aneurysms, which were not amenable to coiling [2, 3]
We aimed to examine aneurysm hemodynamics with intra-saccular pressure measurement, and compare the effects of coiling, stenting and stent-assisted coiling in proximal segments of intracranial circulation
Intra-aneurysmal pressure measurements were performed in 45 patients (4 men and 41 women, aged 67.3±4.6 years and 58.2±13.6 years, respectively)
Summary
Endovascular coiling has an established position in treatment of intracranial aneurysms. [1] Self-expandable stents extended the indications for endovascular therapy for wide-necked and complex aneurysms, which were not amenable to coiling [2, 3]. Endovascular coiling has an established position in treatment of intracranial aneurysms. [1] Self-expandable stents extended the indications for endovascular therapy for wide-necked and complex aneurysms, which were not amenable to coiling [2, 3]. Placement of the stents across the aneurysm neck provides the scaffold for the coils, stabilizing their position and preventing the protrusion into the parent artery. Stent struts cover the aneurysm orifice, and modify the inflow of blood into the sac. This effect is thought to be dependent on strut density and the degree of blood inflow impairment [4,5,6].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
