Endovascular treatment of recurrent intracranial aneurysms with re-coiling or covered stents

Abstract

Recurrent aneurysms after coiling can be successfully treated and occluded with re-coiling or covered stent placement. However, covered stents seem to be more effective than re-coiling with regard to complete occlusion of recurrent aneurysms.

Endovascular treatment of post-traumatic direct carotid-cavernous fistulas: A single-center experience

“…All microcatheter and Willis covered stent insertion procedures were based on our previously described techniques and clinical experience. 16,17 All patients were followed-up for between 3 and 48 months (mean = 20.8 months), and angiograms were performed at 3, 6 and 12 months to assess whether there was occlusion of the fistula, ICA patency, stent stenosis, and pseudoaneurysm formation.…”

Comparative study of covered stent with coil embolization in the treatment of cranial internal carotid artery aneurysm: a nonrandomized prospective trial

“…Based on previous studies [5-9, 11, 12, 20], we predicted that the complete occlusion rate during the 6-month angiographic follow-up period would be <65% (mean 62.5%) with coil embolization and >90% with the covered stent [26,27]. We estimated that 80-90 patients would need to be enrolled for the study to have a statistical power of 80%.…”

“…Our preliminary results with this stent indicate good flexibility and efficacy in cranial internal carotid artery (CICA) aneurysm treatment in patients without an extremely tortuous internal carotid artery (ICA) [26]. We also found that covered stents are more effective than recoiling with respect to the complete occlusion of recurrent aneurysms [27]. Here we present the results of a nonrandomized prospective trial of the endovascular treatment of CICA aneurysms with a covered stent or coil embolization, with the goal of comparing the efficacies of these two treatment approaches.…”

“…Willis covered stents of 3.5, 4.0, 4.5, and 5.0 mm in diameter and 7, 10, 13, 16, and 19 mm in length are available. Stent placement and peri-procedure management were described previously [26][27][28]. Generally, we usually chose a stent that was 2 mm longer at each ends than the aneurysmal ncek.…”

“…The Willis balloon-expandable covered stent has been described in detail previously [26][27][28]. Briefly, the stent consists of three parts: a bare stent, expandable polytetrafluoroethylene (ePTFE) membrane, and balloon catheter.…”