Romanian Neurosurgery (May 2010)
Neuroform stent – assisted coil embolization
Abstract
Objective: To present detailed results of our treatment experience in using Neuroform Stent-Assisted Coil embolization to treat complex cerebral aneurysms over 3-year period, emphasizing on the technical difficulties, procedure-related complications, and to evaluate midterm results. Methods: Patients underwent Neuroform stent-assisted coil embolization were registered in a database. We assessed patients’ history, aneurysm morphology, indications for stenting, and technical details of the procedures, complications and midterm follow-up data. Results: This study included twenty-six patients with 39 aneurysms. A total of 32 of 39 aneurysms were treated by Neuroform stent-assisted embolization (SAC). Three anuerysms stented without coiling, 2 aneurysms coiled without stenting and 2 aneuysms surgically clipped. The indications for use included broad-necked aneurysms (n = 28), giant or large aneurysms (n = 6), and fusiform aneurysms (n = 5). Of the 32 aneurysms treated by Neuroform SAC, we achieved complete (100%) and near complete (> 95%) occlusion in 27 aneurysms, and Partial (< 95%) occlusion in 5 aneurysms. Follow-up angiographic data avialble in 22 of 32 aneurysms treated by Neuroform SAC (68.7%) (average follow-up, 12 mo; range 4–24 mo) demonstrating recanalization in 3 aneurysms (13.6%), and stable occlusion in 19 aneurysms (86.4%). No delayed progressive embolization or in-stent stenosis observed. Conclusion: Neuroform microstent system led to a significant evolution in the endovascular treatment of complex intracranial aneurysms. Our results and midterm follow-up showed Neuroform stent-assisted coil embolization is safe and effective technique in the treatment of complex cerebral aneurysms. Although, the clinically significant complications are uncommon and the evaluation at midterm follow-up is encouraging, further studies needed to assess the long-term stability and durability of the stent.
