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KMID : 1155820150100020089
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Neurointervention
2015 Volume.10 No. 2 p.89 ~ p.93
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Does a Low-wall Coverage Stent Have a Flow Diverting Effect in Small Aneurysms?
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Liu Hairi
Choe Joo-Ae
Jung Seung-Chul
Song Yun-Sun
Yang Ku-Hyun
Park Kye-Jin
Goo Hae-Won
Park Won-Hyong
Suh Dae-Chul
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Abstract
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Backbround and Purpose: The flow diverting effect of a low-wall coverage stent remains controversial. We evaluted patients who underwent stenting for small aneurysms with a low but potential risk of growth and reviewed related literature.
Materials and Methods: We evaluated 9 small aneurysms among 19 unruptured intracranial aneurysms from eight patients who underwent stenting. The patients had unexplainable severe headache (n = 8), aneurysm originating from the anterior choroidal artery (n = 3), potential growth or rupture risks including hypertension (n = 5), and multiple aneurysms (n = 6). Stents with a relatively low-wall coverage ratio (8-10%) were used. Clinical and angiographic outcomes were assessed.
Results: One (n = 8) or two stents (n = 1) were used without any procedural difficulties or complications. Although no immediate changes of aneurysm morphology were observed, aneurysms decreased in size (n = 8) when examined by DSA (n = 8) or MRA (n = 1) during a median 28.9-month follow-up. There were no adverse events, including thromboembolism, aneurysm rupture, or stent movement during a median 31.9-month clinical follow-up (range: 17-69 months).
Conclusion: Although a variable degree of aneurysm size decrease may not prevent further growth or rupture of small aneurysms, stenting with a low-wall coverage ratio may have some advantageous hemodynamic effect. Flow modification of stent architecture vs. aneurysm characteristics, including size and location, on long-term outcome, requires further clarification.
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KEYWORD
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Stent, Intracranial aneurysm, Hemodynamics
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