Temporary Solitaire Stent Scaffolding during Cerebral Aneurysm Coil Embolization

Abstract

Background: Endovascular therapy gains acceptance as an alternative to open surgical clipping for an ever increasing subset of ruptured and unruptured brain aneurysms. Despite ongoing improvements of hardware and technique, coil embolization of distally located wide neck aneurysms remains associated with a comparatively higher rate of coil basket instability, coil mass compaction, and hence the risk of aneurysm reperfusion and recurrence over time. Balloon remodeling harbors the hazard of ischemia secondary to the transient flow arrest within the parent artery or trapped branches. Vessel rupture may also become a concern particularly during multiple balloon inflations and deflations in small diameter arteries. Stent-remodeling and flow-diversion strategies generally require instituting prolonged antiplatelet coverage; which is largely felt to complicate patient management particularly in the context of recent aneurysm rupture.