Clinical and Angiographic Outcomes of Wide-necked Aneurysms Treated with the Solitaire AB Stent

Lee, Sang Yoon; Chae, Kil-Sung; Rho, Seung-Jin; Choi, Hak-Ki; Park, Hwa-Seung; Ghang, Chang-Gu

doi:10.7461/jcen.2013.15.3.158

Cited by 12 publications

(8 citation statements)

References 18 publications

(35 reference statements)

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“…Excellent flexibility and an easy delivery system through Rebar 0.018 or 0.027 inch microcatheters are needed in order to maximize the high navigability of stents. 22) 25) …”

Section: Discussionmentioning

confidence: 99%

Outcomes of Stent-assisted Coil Embolization of Wide-necked Intracranial Aneurysms Using the Solitaire™ AB Neurovascular Remodeling Device

Jeong

Seung

2015

J Cerebrovasc Endovasc Neurosurg

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ObjectiveThis retrospective study presents our experience with respect to the clinical and angiographic outcomes of patients treated with stent-assisted coil embolization using Solitaire™ AB stents.Materials and MethodsFrom March 2011 to December 2014, 50 patients with 55 wide-necked and/or complex intracranial aneurysms were evaluated. Four patients presented with an acute subarachnoid hemorrhage. Stent deployment was performed with a standard coiling procedure in 49 aneurysms. Three patients underwent bailout stenting, 2 patients were treated by temporary stenting and one patient was treated only by stenting without coiling for dissecting aneurysm.ResultsSuccessful placement of the Solitaire AB stent was achieved in all the cases. Based on the postprocedural angiographic results, a Raymond 1 was obtained in 32 (59%) of 54 aneurysms, excluded by one case of dissecting aneurysm, and a Raymond 2 in 13 (24%), and a Raymond 3 in 9 (17%). There was one thromboembolic (2%) and three hemorrhagic complications (6%). However, procedure-related morbidity or mortality was not found. Annual follow-up angiographic results from the embolization were obtained in 40 (74.1%) of 54 cases. These results were represented as Raymond 1 in 27 (67.5%), class 2 in 9 (22.5%), and class 3 in 4 (10%) cases. Angiographic improvement associated with progressive thrombosis of the aneurysm was obtained in 10 aneurysms. Four aneurysms were recanalized without requiring additional treatment. In-stent stenosis was found in one aneurysm, but stent migration was not seen on follow-up angiography.ConclusionStent-assisted coil embolization using the Solitaire AB stent for treating wide-necked and/or complex intracranial aneurysms was found to be safe and effective immediately post-embolization and after follow-up. Long-term follow-up will be required to identify the effect of the Solitaire AB stent on recanalization rates.

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“…Excellent flexibility and an easy delivery system through Rebar 0.018 or 0.027 inch microcatheters are needed in order to maximize the high navigability of stents. 22) 25) …”

Section: Discussionmentioning

confidence: 99%

Outcomes of Stent-assisted Coil Embolization of Wide-necked Intracranial Aneurysms Using the Solitaire™ AB Neurovascular Remodeling Device

Jeong

Seung

2015

J Cerebrovasc Endovasc Neurosurg

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“…Although these led to improved outcomes, the reported complete occlusion rate of BAC and SAC was not satisfactory in follow-up angiographies. Complete occlusion was seen in 71-72% of intracranial aneurysms treated with BAC 21 , 23) and 57-61% in those treated with SAC 5 , 14 , 22) . Although recent studies have reported favorable results in complex aneurysms, the long-term durability and the safety of wide-necked intracranial aneurysms treated with coiling are still questionable.…”

Section: Introductionmentioning

confidence: 97%

Angiographic Results of Wide-Necked Intracranial Aneurysms Treated with Coil Embolization : A Single Center Experience

Song

Chang

Ahn

et al. 2015

J Korean Neurosurg Soc

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ObjectiveEndovascular treatment of wide-necked intracranial aneurysms is a challenge and the durability and the safety of these treated aneurysms remain unknown. The aim of this study was to evaluate the clinical and long-term angiographic results of wide-necked intracranial aneurysms treated with coil embolization.MethodsBetween January 2002 and December 2012, 53 wide-necked aneurysms treated with coil embolization were selected. Forty were female, and 13 were male. Twenty eight (52.8%) were ruptured aneurysms, and 25 (47.2%) were unruptured aneurysms. The patents' medical and radiological records were reviewed retrospectively.ResultsOf the 53 aneurysms, coiling alone was employed in 45 (84.9%) and stent-assisted coiling was done in 8 (15.1%). The initial angiographic results revealed Raymond class 1 (complete occlusion) in 30 (56.6%) cases, Raymond class 2 (residual neck) in 18 (34.0%) cases, and Raymond class 3 (residual sac) in 5 (9.4%) cases. The mean angiographic follow-up period was 37.9 months (12-120 months). At the last angiographies, Raymond class 1 was seen in 26 (49.1%) cases, Raymond class 2 in 16 (30.2%), and Raymond class 3 in 11 (20.8%). Angiographic recurrence occurred in 22 (41.5%) patients, with minor recurrence in 7 (13.2%) cases and major recurrence in 15 (28.3%). Retreatment was performed in 8 cases (15.1%). A suboptimal result on the initial angiography was a significant predictor of recurrence in this study (p=0.03).ConclusionThe predictor of recurrence in wide-necked aneurysms is a suboptimal result on the initial angiography. Long-term angiographic follow-up is recommended in wide-necked aneurysms.

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“… 7) 9) Previous studies reported excellent results of stent navigation and deployment in both stent groups (success rate: 97.1% for Enterprise stents and 98.1% for Solitaire stents). 1) 2) 9) 10) 13) 15) 16) 17) 18) 19) Among our cases, there were no failures or difficulties in stent navigation or deployment. Clinical and angiographic outcomes did not show significant correlation with patient age, patient sex, aneurysm size, or aneurysm type.…”

Section: Discussionmentioning

confidence: 61%

“… 5) 9) SAC has various advantages. For example, it creates a barrier which can prevent coil herniation into the parent vessel lumen, facilitates increased overall coil packing density, 16) and provides flow diversion. Currently, two self-expanding closed-cell stents, the Enterprise VRD stent (Codman, Miami, FL, USA) and the Solitaire AB stent (Covidien, Irvine, CA, USA), are widely used for SAC of wide-neck or complex intracranial aneurysms.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have reported results relevant to each stent, including clinical and angiographic outcomes, procedural feasibility, and complications. 4) 5) 12) 16) 18) However, few studies have compared the results of Enterprise and Solitaire SAC for wide-neck or complex intracranial aneurysms. The purpose of this study was to compare Enterprise and Solitaire SAC in terms of several clinical findings and the related follow-up results.…”

Section: Introductionmentioning

confidence: 99%

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Clinical and Angiographic Outcomes of Aneurysms Treated with Two Self-expanding Stent-assisted Coiling Systems: A Comparison of Solitaire AB and Enterprise VRD Stents

Kim

Sung

Chae

et al. 2015

J Cerebrovasc Endovasc Neurosurg

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ObjectiveThe purpose of this study was to compare clinical findings and outcomes of Enterprise and Solitaire stent-assisted coiling (SAC).Materials and MethodsBetween January 2012 and March 2014, 86 patients (mean age, 60.3 years) harboring 89 aneurysms were treated with Enterprise (n = 57) or Solitaire (n = 32) SAC. The patients' demographics, angiographic results, and clinical outcomes were reviewed retrospectively.ResultsThere were no cases of stent navigation, deployment failure, arterial dissection, or intraoperative aneurysmal rupture. Angiographic follow-up imaging was available for 86 (96.6%) aneurysms (Enterprise group, n = 55; Solitaire group, n = 31). Immediate postoperative and follow-up angiographic results showed no flow or only minimal flow into the neck in 83% (Enterprise group, 77.2%; Solitaire group, 93.8%) and 95.3% (Enterprise group, 92.7%; Solitaire group, 100%) of SAC-treated aneurysms, respectively. Both stent groups showed good immediate postoperative and follow-up clinical outcomes. Excepting 2 cases, all patients achieved modified Rankin Scale scores of 0. Coil loop or tail protrusion into the parent artery was observed in 17 (29.8%) and 7 (21.9%) cases in the Enterprise and Solitaire groups, respectively. No statistically significant difference in terms of angiographic results or clinical outcomes was observed between the groups.ConclusionExcellent and comparable clinical and angiographic outcomes for wide-neck intracranial aneurysms were achieved using both stents. Because of its higher radial strength and better vessel wall apposition, we cautiously propose that the Solitaire stent may be more effective for SAC of aneurysms harboring a large or severe tortuous parent artery.

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Clinical and Angiographic Outcomes of Wide-necked Aneurysms Treated with the Solitaire AB Stent

Cited by 12 publications

References 18 publications

Outcomes of Stent-assisted Coil Embolization of Wide-necked Intracranial Aneurysms Using the Solitaire™ AB Neurovascular Remodeling Device

Outcomes of Stent-assisted Coil Embolization of Wide-necked Intracranial Aneurysms Using the Solitaire™ AB Neurovascular Remodeling Device

Angiographic Results of Wide-Necked Intracranial Aneurysms Treated with Coil Embolization : A Single Center Experience

Clinical and Angiographic Outcomes of Aneurysms Treated with Two Self-expanding Stent-assisted Coiling Systems: A Comparison of Solitaire AB and Enterprise VRD Stents

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