Solitaire AB stent-assisted coil for embolization of wide-necked cerebral aneurysms: an analysis of complications

Abstract

Objective To investigate the perioperative complications and treatment measures of Solitaire AB stent for embolization of wide-necked cerebral aneurysms. Methods The clinical and imaging data of 116 patients with wide-necked cerebral aneurysms treated by using Solitaire AB stent-assisted embolization at the Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University from February 2010 to February 2014 were analyzed retrospectively. The perioperative complications were observed. Its causes of occurrence were analyzed and the corresponding treatment measures were investigated. Results All stents were successfully implanted in place. The results of immediate DSA examination revealed that 55 of 120 aneurysms were embolized completely. There were 59 residual aneurysm necks, 6 aneurysms were embolized partially. Ten patients had perioperative complications, 3 were intraoperative aneurysm rupture, the bleeding of 2 patients was stopped after emergency packing, and 1 patient died; after having intraparenchymal hemorrhage, 1 patient died of herniation at 5 h after stenting; 4 had thrombotic complications, 3 of them had blood flow recanalization after in-stent thrombolysis, and the efficacy of 1 case was poor and his blood flow was patent after a new Solitaire stent implantation; 2 had stent migration when the stent was not detached during procedure, fortunately, it did not cause significant neurological damage. After procedure, 114 patients were followed up for 3 to 37 months. Twelve patients had aneurysm recurrence and 5 were treated with intervention therapy again. Conclusions Solitaire AB stent-assisted coil embolization for the treatment of wide-necked aneurysms is a mature technique, but there are some complications. Therefore, the surgeons need to have good operative skills and rich experience. At the same time, the perioperative management should be strengthened in order to reduce the occurrence of complications and improve the prognosis of patients. Key words: Intracranial aneurysm; Intraoperative complications; Wide-necked; Stent