Stent-assisted Coiling of Acutely Ruptured Cerebral Aneurysms

Abstract

Purpose:The usefulness of stent-assisted coiling (SAC) of ruptured cerebral aneurysms has been reported, but a consensus has not been reached. We review the merits and limitations of this procedure based on our series. Subjects and Methods:Out of 96 ruptured cerebral aneurysms treated by endovascular treatment between July 2010and July 2016, five (5%) had SAC. We investigated this group's clinical characteristics, postoperative complications, and modified Rankin Scale (mRS) score after 6 months. Results:In all five patients, it was possible to insert a stent without difficulties, and there were no procedure-related complications. Diffusion-weighted brain MR images showed high-signal-intensity "spot-like" areas in all patients, remaining as asymptomatic cerebral infarctions and all stents remained completely patent. A hemorrhagic complication was observed in one patient who underwent later ventricle drainage. The mRS scores after 6 months were 0 in one patient, 1 in one patient, 3 in one patient, 4 in one patient, and 6 in one patient.Conclusion: SAC of ruptured cerebral aneurysms could be considered a useful treatment option although indicated for a limited number of patients with adequate use of antiplatelet treatment and cerebral spinal fluid (CSF) drainage for the subarachnoid hemorrhage (SAH).