Abstract
Aneurysms are rarely associated with symptomatic intracranial stenosis. We report the results of recanalization by stent placement in patients with symptomatic severe intracranial stenosis associated with adjacent aneurysms. Of 139 patients who underwent intracranial stent placement during a 5-year period, 10 (7%) had symptomatic severe intracranial stenosis associated with adjacent aneurysms. Five were in the VA, 3 in the BA, and 2 in M1. The types of aneurysm were atherosclerotic fusiform (n = 5), ulcerative (n = 4), and saccular (n = 1). We analyzed angiographic findings based on biplane and 3D angiograms and assessed patient outcomes and complications after stent placement. The results were compared with those of a control group without aneurysms who underwent stent placement during the same study period. Aneurysm locations were post- (n = 6), in- (n = 2), and pre-stenotic (n = 2). After angioplasty with stent placement and/or aneurysm embolization, there were no lesion-related strokes or deaths during a median follow-up period of 25 months (range, 11-43 months). One patient had asymptomatic restenosis. The final mRS score was good (≤2) in all patients. There were no statistically significant differences in event or restenosis rates compared with the control group. Adjacent aneurysms were rarely associated with severe intracranial stenosis but were more common in the posterior circulation. Intracranial stent placement may be performed without additional stroke risk, regardless of the type and location of the aneurysm.
Highlights
AND PURPOSE: Aneurysms are rarely associated with symptomatic intracranial stenosis
Adjacent aneurysms were rarely associated with severe intracranial stenosis but were more common in the posterior circulation
Intracranial angioplasty and stent placement have become therapeutic options for patients with symptomatic intracranial arterial stenoses unresponsive to medical therapy.[3,4,5,6]
Summary
Of 139 patients who underwent intracranial stent placement during a 5-year period, 10 (7%) had symptomatic severe intracranial stenosis associated with adjacent aneurysms. Review of the prospectively collected neurointerventional data registry of the Asan Medical Center showed that of the 139 consecutive patients who underwent intracranial stent placement between August 2003 and December 2008, 10 (7%) had aneurysms. All such patients had symptomatic severe intracranial (Ն70%) stenoses associated with adjacent aneurysms in the same arterial anatomic segment.[5,8] We excluded patients with acute or unstable stroke and those with aneurysms not adjacent to stenoses (n ϭ 8).
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