Neuropsychiatric Disease and Treatment (Jan 2022)

Willis Covered Stent for Treating Intracranial Pseudoaneurysms of the Internal Carotid Artery: A Multi-Institutional Study

  • Lu D,
  • Ma T,
  • Zhu G,
  • Zhang T,
  • Wang N,
  • Lei H,
  • Sui J,
  • Wang Z,
  • He S,
  • Chen L,
  • Deng J

Journal volume & issue
Vol. Volume 18
pp. 125 – 135

Abstract

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Dan Lu,1,* Tao Ma,1,* Gemin Zhu,2,* Tao Zhang,3 Naibing Wang,1 Hui Lei,2 Jing Sui,1 Zhiguo Wang,1 Shiming He,1 Lei Chen,1 Jianping Deng3 1Department of Neurosurgery, Xi’an International Medical Center Hospital, Xi’an, People’s Republic of China; 2Department of Neurology, Xi’an Central Hospital, Xi’an, People’s Republic of China; 3Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi’an, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianping DengDepartment of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi’an, People’s Republic of China, Email [email protected]; Lei ChenDepartment of Neurosurgery, Xi’an International Medical Center Hospital, Xi’an, People’s Republic of China, Email [email protected]: This work aimed to retrospectively analyze Willis covered stent (WCS)’s therapeutic efficacy in intracranial pseudoaneurysms (PSAs) of the internal carotid artery (ICA).Methods: Between June 2018 and July 2021, 56 individuals with intracranial PSAs of the ICA treated with WCS in three centers were included to analyze information regarding medical records, operative parameters, imaging findings and follow-up data.Results: All WCSs were successfully targeted to the ICA lesions. Total exclusion of PSA was found in 53 cases (94.6%) right upon surgery, and mild endoleak into the aneurysm remained in 3 cases (5.4%). Intraoperative thrombosis occurred in 1 case (1.8%), and tirofiban was utilized for recanalization. Follow-up by angiography showed total aneurysm occlusion in the total number of individuals, including in the 3 above cases with residual endoleak. In-stent stenosis occurred in 7 (12.5%) patients. No stent-related ischemic event was encountered. Predictive factors of late in-stent stenosis following WCS implantation in this patient group were irregular post-operative antiplatelet treatment (p = 0.015) and C4-C5 segment of the ICA (p = 0.043).Conclusion: WCSs are effective in treating intracranial PSAs of the ICA.Keywords: Willis covered stent, intracranial pseudoaneurysms, internal carotid artery, endoleak, in-stent stenosis

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