Abstract

Background: Self-expanding devices, such as the Enterprise VRD (EP-VRD) have widely used for stent-assisted coiling treatment in wided-necked aneuryms while some thromboembolic complications were reported due to its incomplete stent apposition (ISA). We report our experiences on the novel Enterprise2 (EP-VRD2) stent in vivo in the treatment of intracranial and cranial cervical junction aneurysms.Methods: Twenty-five consecutive patients with intracranial or cranial cervical junction aneurysms were treated with EP-VRD2 stents retrospectively collected in our institution. We use the ‘jailing' technique in all cases and deployed the stent by using pushing over the outer curve technique. The 3- or 6-monthS follow-up was done regularly by DSA.Results: Twenty-five EP-VRD2 stents were implanted to treat 21 aneurysms at the siphon segment of internal carotid artery (ICA), one at the petrous segment, two at the cervical segment, one at the verteral artery with five accompanied with stenosis. Two patients had kinking during the procedure and were solved by microwire or microcatheter massaging. Four patients with a larger arc angle and a smaller radius of the parent vessel was detected ISA. No patient underwent the ischemic event after the operation. Twenty-three of 25 patients were evaluated after 3- or 6-months by DSA, 22 showed complete occlusion (RROC1), one slight re-stenosis in the follow-up within those five patients with stenosis. A length of 23 mm seemed associated with ISA (p < 0.01).Conclusion: The EP-VRD2 performed well in our small patient series; however, ISA could still occur with a sharp angle of the parent vessel.

Highlights

  • Novel endovascular devices and technologies have increased opportunities for treatment of intracranial aneurysms (IAs)

  • Short-Term Results on EP2 widely used in stent-assisted coiling (SAC) treatment of IAs [5,6,7]

  • We retrospectively collected the data from 25 patients with intracranial or cranial cervical junction aneurysms treated with EP-VRD2 from November 2018 to December 2019 at our institution

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Summary

Introduction

Novel endovascular devices and technologies have increased opportunities for treatment of intracranial aneurysms (IAs). These include surgical clipping, even in complex aneurysms. Johnson et al reported that 4.4–6.4% [8] of patients who underwent SAC treatment had thromboembolic complications partially due to the incomplete stent apposition (ISA) in blood vessels with large diameters and curvatures [9]. Self-expanding devices, such as the Enterprise VRD (EP-VRD) have widely used for stent-assisted coiling treatment in wided-necked aneuryms while some thromboembolic complications were reported due to its incomplete stent apposition (ISA). We report our experiences on the novel Enterprise (EP-VRD2) stent in vivo in the treatment of intracranial and cranial cervical junction aneurysms

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