In vitro experiments of vessel wall apposition between the Enterprise and Enterprise 2 stents for treatment of cerebral aneurysms

Kono, Kenichi; Terada, Tomoaki

doi:10.1007/s00701-015-2666-3

Cited by 14 publications

(8 citation statements)

References 14 publications

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“…Although this was an in vitro study, it demonstrated the superiority of Enterprise VRD2 over Enterprise VRD under the same experimental conditions. This result is consistent with a report by Kono and Terada 12. In addition, in this study, the stents were deployed under fluoroscopy, in order to more closely simulate clinical conditions.…”

Section: Discussionsupporting

confidence: 92%

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Deployment technique that takes advantage of the characteristics of Enterprise VRD2: an in vitro study

Chihara

Ishii

Kikuchi

et al. 2016

J NeuroIntervent Surg

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Section: Discussionsupporting

confidence: 92%

“…Kono and Terada12 showed in an in vitro study that Enterprise VRD2 demonstrated better wall apposition in curved vessels than Enterprise VRD. However, they cautioned that ISA might still occur when using Enterprise VRD2 12…”

Section: Introductionmentioning

confidence: 99%

Deployment technique that takes advantage of the characteristics of Enterprise VRD2: an in vitro study

Chihara

Ishii

Kikuchi

et al. 2016

J NeuroIntervent Surg

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“…To overcome this weakness, the Enterprise2 stent (EP-VRD2) was developed; it is the second-generation Enterprise stent, featuring improved design in terms of geometry. EP-VRD2 showed better wall apposition in curved vessels than did EP-VRD in an in vitro study (10). Clinicians could further reduce ISA in curved vessels by pushing over the outer curve deploying technique (11).…”

Section: Introductionmentioning

confidence: 94%

The Enterprise2 Stent for Endovascular Treatment of Intracranial Aneurysms: Short-Term Results From a Single Center Experience

Chen

Zheng

et al. 2020

Front. Neurol.

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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.

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“…Heller et al [ 12 ] first reported that EP stents were prone to malposition in vessels with a large curvature. In 2016, Kono et al [ 13 ] tested release of the EP and EP2 stents in vitro and found that the gap between the stent and the tube wall was twice as large for the EP stent, indicating that the EP2 stent has better stent-vessel apposition. Herweh et al [ 7 ] first studied the application of the EP2 stent in clinical patients and reported good safety and effectiveness; however, incomplete stent apposition still occurred in the vessels with a large curvature.…”

Section: Discussionmentioning

confidence: 99%

Effects of Enterprise 2 stent-assisted coil embolization for wide-necked intracranial aneurysms

Zhou

Peng

2022

Chin Neurosurg Jl

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Background This study analyzed the safety and efficacy of Enterprise 2 stent-assisted coil embolization for wide-necked intracranial aneurysms by examining stent-vessel apposition, operative complications, embolization outcomes, and clinical outcomes. Methods We retrospectively reviewed the medical records of patients with wide-necked intracranial aneurysms who underwent Enterprise 2 stent-assisted coiling in our hospital from November 2018 to October 2019. Intraoperative VasoCT was performed immediately after stent release in a continuous cohort of patients to observe stent-vessel apposition. Patient demographic, clinical, and imaging data were recorded and analyzed. Results A total of 106 wide-necked aneurysms in 106 patients were treated. Stent release was successful in all patients. Twenty-one patients were enrolled consecutively for VasoCT scanning, and incomplete stent apposition was observed in 5 (23.8%). Perioperative complications occurred in 10 patients (9.4%): cerebral infarction in 6, intraoperative coil prolapse in 1, puncture site pseudoaneurysm in 1, deep vein thrombosis at multiple sites in 1, and transient brainstem mass effect in 1. Among the 95 aneurysms with angiographic follow-up, embolization was satisfactory (Raymond–Roy classifications I and II) in 89 (93.7%). Hyperlipidemia was an independent risk factor for incomplete aneurysm occlusion. At the last clinical follow-up, seven patients had a poor clinical outcome (modified Rankin Scale score ≥ 3). Independent risk factors for poor outcomes were preoperative subarachnoid hemorrhage at presentation and cerebral infarction. Conclusion Enterprise 2 stent-assisted coiling for treatment of wide-necked intracranial aneurysms showed good safety and efficacy; however, incomplete stent apposition can still occur in vessels with a large curvature. Preoperative subarachnoid hemorrhage at presentation and cerebral infarction are the main reasons for poor clinical outcomes after stent-assisted coil embolization.

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In vitro experiments of vessel wall apposition between the Enterprise and Enterprise 2 stents for treatment of cerebral aneurysms

Cited by 14 publications

References 14 publications

Deployment technique that takes advantage of the characteristics of Enterprise VRD2: an in vitro study

Deployment technique that takes advantage of the characteristics of Enterprise VRD2: an in vitro study

The Enterprise2 Stent for Endovascular Treatment of Intracranial Aneurysms: Short-Term Results From a Single Center Experience

Effects of Enterprise 2 stent-assisted coil embolization for wide-necked intracranial aneurysms

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