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Forward deployed coil embolization with multiple overlapping stents for ruptured blood blister-like aneurysms: technical considerations and outcomes

Authors
Kim, MJ; Chung, J; Shin, YS; Lim, YC
Citation
Neurological research, 41(6). : 562-568, 2019
Journal Title
Neurological research
ISSN
0161-64121743-1328
Abstract
BACKGROUND: Coil embolization with multiple overlapping stents was performed as an alternative treatment option for blood blister-like aneurysms (BBAs). However, coil placement into the BBAs has the inherent risks of rupture and regrowth. We describe a safe dense coil packing technique into and just proximal of BBAs using a semi-jailing technique for the treatment of BBAs of the internal carotid artery (ICA) and report the long-term clinical outcomes.
METHODS: The technique involves the partial deployment of a self-expanding and retrievable stent from the ICA bifurcation to the mid-portion of a BBA followed by coil embolization with gradual unsheathing of the stent from the BBA to its just proximal portion. Seventeen patients were treated using this technique (10 women: mean age, 47.9 +/- 11 years: overall mean clinical follow-up period, 42.3 +/- 22.8 months). Technique safety and feasibility, and follow-up angiographic results and clinical outcomes (modified Rankin Scale, mRS) were evaluated.
RESULTS: Procedures were successfully applied without any procedure-related complications. Immediate post-treatment angiograms showed total obliteration of the BBAs in all 17 patients. Follow-up angiograms, which were available in 15 (88.2%) patients, showed complete resolution of BBAs. Fourteen (82.4%) of 17 patients achieved favorable clinical outcomes (mRS CONCLUSIONS: Forward deployed coil embolization with multiple overlapping stents offers a safe and effective reconstructive endovascular technique for the treatment of the BBAs.
Keywords
Blood blister–like aneurysmmultiple overlapping stentsstent-assisted coilingsubarachnoid hemorrhage
MeSH terms
AdultAgedAneurysm, Ruptured / complicationsAneurysm, Ruptured / surgery*Blood Vessel ProsthesisCarotid Artery Diseases / complicationsCarotid Artery, Internal / surgery*Embolization, Therapeutic / methodsEndovascular Procedures*FemaleHumansIntracranial Aneurysm / surgery*MaleMiddle AgedStents* / adverse effectsSubarachnoid Hemorrhage / complicationsTreatment Outcome
DOI
10.1080/01616412.2019.1584424
PMID
30821662
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
AJOU Authors
임, 용철
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