Neuroform stent-assisted coiling of intracranial aneurysms: a 5 year single-center experience and follow-up

Abstract

Background and purpose: Wide-necked and fusiform aneurysms still remain a therapeutic challenge both surgically and endovascularly. The authors report their clinical experience and 5 year follow-up results using Neuroform stent, as an adjunct in the treatment of wide-necked and fusiform aneurysms.Methods: One hundred and seven consecutive patients with 110 wide-necked or fusiform intracranial aneurysms were treated with the Neuroform stent-assisted coiling. Both sequential technique and parallel technique were used. In all cases, embolization was completed by packing the aneurysm sac with a variety of commercially available coils. The technical feasibility of the procedure, procedure-related complications, angiographic results, clinical outcome and follow-up angiography were evaluated.Results: In every case, the Neuroform stent system was delivered and deployed accurately, and occlusion was achieved. Immediate angiography demonstrated complete occlusion in 57·2%, neck remnant in 27·3% and incomplete occlusion in 15·5%. Procedure-related morbidity was 5·6% and procedural-related mortality was 0·9%. Favorable clinical outcome (modified Rankin scale score: 0–2) was observed in 90·7% of the patients (average follow-up time: 47·3 months). No rehemorrhage of treated aneurysm occurred. Angiography follow-up was obtained in 45·8% (49/107 patients; 51/110 aneurysms; average follow-up time: 37·2 months). The overall recanalization rate was 13·7%. Comparison of occlusion class immediately after treatment and at last follow-up showed that 86·3% of the 51 aneurysms had stable or improved class. Eight aneurysms (36·4%) that were not initially completely occluded converted to complete occlusion on follow-up. No delayed coil or stent migration was found. One patient with in-stent stenosis and one with penetrating artery occlusion occurred as delayed complications.Conclusion: In treating complex intracranial aneurysms, the Neuroform stent-assisted coiling is a secure and effective technique.