The effect of embolization assisted with varying stent release methods in the treatment of intracranial wide-neck bifurcation aneurysms

Abstract

Objective To investigate the safety and efficacy of embolization assisted with varying stent release methods in the treatment of intracranial wide-neck bifurcation aneurysms (WNBA). Methods A retrospective analysis was conducted on 62 patients with WNBA treated with varying stent release methods at Department of Neuro-intervention, the First Affiliated Hospital of Zhengzhou University from May 2012 to May 2017. Among them, 14 patients were treated with waffle cone technique, 29 with double stents in Y configuration, 1 with double stents in X configuration and 18 with LVIS Barrel technique. Results Except 1 case that failed to be treated with Y configuration, the others underwent successful operations. According to the Raymond classification, the immediate procedural outcome was Class I in 30 (48.4%) patients, Class II in 21 (33.9%) and Class Ⅲ in 11 (17.7%). Perioperative ischemic complications occurred in 6 (9.68%) cases including intraoperative thrombosis in 2 cases and acute ischemic complications post operation in 4. Postoperative thalamic hemorrhage was reported in 1 (1.6%) case. Clinical follow-up lasted for 5-57 months, with an average of 11.9±1.7 months. For 59 cases, the mRS (modified Rankin scale) score was 0-1 in 55 (93.2%) cases, 2-3 in 2 (3.4%) and 4-5 in 5 (3.4%). Angiographic follow-up at 3-36 months in 33 cases showed that aneurysms were completely occluded in 18 (54.6%), improved in 5 (15.2%) and remained stable in 9 (27.3%). There was 1 (3.0%) case with aneurysm recanalization that needed retreatment. Conclusions The technical feasibility and safety of embolization assisted with varying stent release methods could be accepted for treatment of intracranial WNBA. However, further studies are needed for evaluation of its long-term efficacy. Key words: Intracranial aneurysm; Embolization, therapeutic; Stents; Bifurcation; Wide-neck