Treatment of Complex Intracranial Aneurysms with a Telescoping Stent Technique

Nohra Chalouhi; Peter Campbell; Yamane Makke; Sanjay Yadla; Aaron S. Dumont; L. Fernando Gonzalez; Stavropoula Tjoumakaris; Barbara Albani; Robert H. Rosenwasser; Pascal Jabbour

doi:10.1055/s-0032-1322589

Journal of Neurological Surgery Part A: Central European Neurosurgery, Table of Contents

J Neurol Surg A Cent Eur Neurosurg 2012; 73(05): 281-288
DOI: 10.1055/s-0032-1322589

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Treatment of Complex Intracranial Aneurysms with a Telescoping Stent Technique

Nohra Chalouhi

¹Department of Neurological Surgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

,

Peter Campbell

¹Department of Neurological Surgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

,

Yamane Makke

²American University of Beirut, Beirut, Lebanon

,

Sanjay Yadla

¹Department of Neurological Surgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

,

Aaron S. Dumont

¹Department of Neurological Surgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

,

L. Fernando Gonzalez

¹Department of Neurological Surgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

,

Stavropoula Tjoumakaris

¹Department of Neurological Surgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

,

Barbara Albani

³Department of Neurointerventional Surgery, Christiana Hospital, Newark, Delaware, United States

,

Robert H. Rosenwasser

¹Department of Neurological Surgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

,

Pascal Jabbour

¹Department of Neurological Surgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States

› Author Affiliations

Abstract

Background and Object Complex intracranial aneurysms present a treatment challenge for both open and endovascular modalities of treatment. This report seeks to illustrate a series of patients with aneurysms treated with telescoping stents as a method of flow diversion for small and fusiform intracranial aneurysms.

Material and Methods A retrospective evaluation of six patients treated with a telescoping stent technique utilizing available stents (at that time before the pipeline era) for complex cerebral aneurysms between January 2009 and January 2010 was performed. Five patients had dissecting aneurysms and one patient had a small superior hypophyseal artery aneurysm. One of the patients was treated in the setting of a Hunt and Hess grade IV subarachnoid hemorrhage. Follow-up cerebral angiography was performed postprocedure at 6 months.

Results At a mean follow-up period of 9 months, all the patients experienced complete or near-complete occlusion (>95%). No periprocedural complications were noted in this series. No episodes of hemorrhage or thromboembolic complications occurred.

Conclusions Overlapping Neuroform and Enterprise stents may induce complete thrombosis of intracranial aneurysms and facilitate parent artery remodeling. The use of self-expanding stents is still an adequate treatment modality, especially if there is a need for vessel wall stabilization rather than flow diversion. The technique is also a sufficient alternative in small intracranial aneurysms not readily amenable to open surgical treatment or traditional endovascular coil embolization.

Keywords

sole stenting technique - aneurysm - endovascular - neuroform - enterprise - telescoping

Full Text

References

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