Endovascular embolization of intracranial wide-necked aneurysms by using Solitaire AB stent as well as coils:an initial experience in 36 patients

Objective To discuss the preliminary experience and clinical results of endovascular embolization by using Solitaire AB Stent as well as coils for the treatment of intracranial wide-necked aneurysms.Methods During the period from May.2010 to March 2011 Solitaire AB stent-assisted coil embolization was carried out in 36 patients with 39 intracranial wide-necked aneurysms.Acute subarachnoid hemorrhage due to the rupture of aneurysm was seen in 15 cases.The aneurysms were located at the anterior communicating artery(n = 1),at the posterior communicating segment of internal carotid artery(n = 13),at the ophthalmic segment of internal carotid artery(n = 13),at the cavernous segment of internal carotid artery(n = 4),at the extra-cranial segment of vertebral artery(n = 1),at the intracranial segment of vertebral artery(n = 4) or at the basilar top(n = 3).The clinical results were evaluated with cerebral angiography at 3 and 12 months after the treatment.Results A total of 38 Solitaire AB stents were used to assist coil embolization management of 39 intracranial wide-necked aneurysms,and the technical success rate was 100%.During the procedure,15 stents needed to be retrieved and repositioned after initial full deployment,and double stenting was performed in 5 cases.After endovascular treatment immediate angiography showed that total occlusion was seen in 30 aneurysms and subtotal occlusion in 9 aneurysms.During the whole procedure,the stent moved back slightly in 1 case,and no evident thromboembolic or rebleeding events occurred.Follow-up angiography was conducted in 27 cases,which showed that delayed coil migration occurred in one case,all the aneurysms that had been totally embolized remained occluded,and 6 of the aneurysms that had been sub-totally embolized became totally occluded.No in-stent stenosis nor aneurysmal re-bleeding occurred.Conclusion The preliminary experience and clinical results of endovascular embolization by using Solitaire AB Stent as well as coils for the treatment of intracranial wide-necked aneurysms are highly encouraging.The technique is very simple,safe and effective.