Thromboembolic Events Associated with Neuroform Stent™ in Endovascular Treatment of Intracranial Aneurysms

Abstract

The incidence of thromboembolic events associated with Neuroform stent (Boston Scientific Target, Fremont, CA) is known from previous studies but there are uncertainties of scale. To report our rate of ischemic events associated with Neuroform stent. Consecutive patients treated with Neuroform stent for intracranial aneurysms were prospectively enrolled from January 2003 to August 2006. Thromboembolic events as well as clinical outcomes were measured. Mean follow-up was 12 months. Successful stent deployment was achieved in (65/67) 97% of patients without any ischemic event. However, postoperative thromboembolic events were observed in 3 patients despite being on clopidogrel and aspirin. These 3 patients demonstrated poor platelet inhibitions in platelet aggregation (aggregometry) studies, and were successfully treated with intravenous eptifibatide with good outcome. The majority of the patients had good outcomes [Glasgow Outcome Score (GOS) 5 or National Institute of Health Stroke Scale (NIHSS) 0 in (63/67) 94%, GOS 4 or NIHSS 2 in 1 patient, and GOS 3 or NIHSS 4 was observed in 3 cases]. Our study reveals that the thromboembolic events associated with Neuroform stent may present in a delayed fashion. These events can be successfully treated with good outcome. Therefore, postoperative close follow-up is strongly recommended for all Neuroform stent-treated patients.