Stent-Assisted Coil Embolization of Posterior Communicating Artery Aneurysms

Abstract

BACKGROUND AND PURPOSE:Use of protective stents may not be effective in coil embolization of wide-neck aneurysms involving the posterior communicating artery. Successful implementation depends on the caliber of the vessel, its angle of origin, and the manner in which its orifice is incorporated into the aneurysm. Presented here are the results (clinical and radiographic) of coil embolization in aneurysms of the ICA-posterior communicating artery junction, variably aided by stents. The primary focus is angiographic configurations that impact stent placement.

Effect of stenting on progressive occlusion of small unruptured saccular intracranial aneurysms with residual sac immediately after coil embolization: a propensity score analysis

“…Dual agent antiplatelet therapy (loading doses of clopidogrel and aspirin (ie, 300 mg each), given 1 day prior, and another 75 mg of clopidogrel and 100 mg of aspirin, given the morning of the procedure) was administered if stent protection (Enterprise stent; Codman, Raynham, Massachusetts, USA; Neuroform stent, Boston Scientific, Natick, Massachusetts, USA) was anticipated 11. In patients were poor responders to clopidogrel, signaled by VerifyNow P2Y12 assay, cilostazol was added.…”

Stent-Assisted Coil Embolization of Vertebrobasilar Dissecting Aneurysms: Procedural Outcomes and Factors for Recanalization

“…Our institutional protocol calls for dual antiplatelet agent use (clopidogrel and aspirin) (11). In poor responders to clopidogrel, signaled by VerifyNow P2Y12 assay (12), cilostazol was added.…”

“…Follow-up radiologic tests were done using time-of-flight magnetic resonance angiography (TOF-MRA) or angiography at 6, 12, 24, and 36 months, as dictated by clinical patient status (141516). Plain radiographs were taken at 1 and 3 months after the procedure to view coil shape in VBDAs presenting with hemorrhage (11). Anatomic outcomes in follow-up were interpreted as complete occlusion (no flow or no contrast filling of aneurysms on MRA or angiography) or recanalization.…”

Fate of Coiled Aneurysms with Minor Recanalization at 6 Months: Rate of Progression to Further Recanalization and Related Risk Factors

“…Dual-agent antiplatelet therapy (loading doses of clopidogrel and aspirin [ie, 300 mg each] given 1 day before the procedure, with an additional morning dose of clopidogrel [75 mg] and aspirin [100 mg] on the day of the procedure) was administered if stent protection was anticipated in patients with unruptured aneurysms. 8 In poor responders to clopidogrel, signaled by VerifyNow P2Y12 assay (Accumetrics, San Diego, California), cilostazol was added. We prescribed single-agent (clopidogrel) therapy if stent placement was not planned, adding aspirin in poor responders.…”