Stent-assisted coiling of wide-neck bifurcation aneurysms with a branch incorporated in the aneurysm base: long-term follow-up in 49 patients with 53 aneurysms

Lubicz, Boris; Morais, Ricardo; Bruyère, Pierre Julien; Ligot, Noémie; Mine, Benjamin

doi:10.1007/s00234-017-1834-y

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…In our study, initial angiographic results (1-3 months) showed complete occlusion (Raymond 1) in 39.8% of the aneurysms, which was similar to the complete occlusion rate of 41% reported by Murayama et al (22). This is also consistent with previous reports, (4,7,9,23,24) and slightly better than other case series (8).…”

Section: Rate Occlusionsupporting

confidence: 94%

Five-Years Angiographic Follow-Up of Wide-Neck Intracranial Aneurysms Treated With LEO Plus Stent

et al. 2021

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Background: This study aimed to evaluate the angiographic and clinical outcome, with an emphasis on long-term follow-up, of the LEO Plus stent for wide-neck intracranial aneurysms treated in a single center.Methods: We retrospectively examined a prospectively maintained database of patients treated with LEO Plus devices between January 2004 and December 2016. Data regarding patient demographics, aneurysm characteristics, and technical procedures were analyzed. Angiographic and clinical findings were recorded during the procedure and followed up over a period of at least 5 years.Results: We identified 101 patients with 116 aneurysms. In 16 patients, the stent could not safely be placed. Thus, a total of 97 LEO Plus devices were implanted in 97 aneurysms of 85 patients. Adverse events (acute and delayed) were observed in 21.6% of cases (17/85), and most were resolved (70.6%; 12/17). Moreover, 5 years after the procedure, total morbidity and mortality were 2.3% (2/85) and 3.5% (3/85), respectively. Long-term imaging follow-up showed complete occlusions, neck remnants, and residual aneurysms in 73.1% (57/78), 14.1% (11/78), and 12.8% (10/78) of cases, respectively.Conclusions: Long-term results of treatment of brain aneurysms with LEO stent show high rates of adequate and stable occlusion over time, with acceptable morbidity and mortality.

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Section: Rate Occlusionsupporting

confidence: 94%

Five-Years Angiographic Follow-Up of Wide-Neck Intracranial Aneurysms Treated With LEO Plus Stent

et al. 2021

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“…At follow-up, 10/55 (18%) intracranial aneurysms had a recanalization, of which six were retreated, which is a notable proportion and, moreover, retreatments are even more challenging in this situation. On the same topic Lubicz et al [23] published their retrospective review of 49 patients with 53 WNBA treated by stent-assisted coiling. The branch that was associated with the aneurysm base was not stented, and they used three types of stents: 42 cases with the Enterprise stent, 4 cases with the Leo Baby stent, and 7 cases with the LVIS Jr stent.…”

Section: Discussionmentioning

confidence: 98%

Y-stenting with braided stents for wide-neck intracranial bifurcation aneurysms. A single-center initial experience

Mihalea

Caroff

Ikka

et al. 2020

Journal of Neuroradiology

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“…18 Stent-assisted coiling remains an excellent endovascular option after more than 20 years with many technical improvements over the years, such as low-profile stents enabling good manipulation to effectively achieve neck coverage and preserve parent arteries thanks to the bulging technique 19 even in the case of a saccular branch. 20…”

Section: Discussionmentioning

confidence: 99%

“…18 Stent-assisted coiling remains an excellent endovascular option after more than 20 years with many technical improvements over the years, such as lowprofile stents enabling good manipulation to effectively achieve neck coverage and preserve parent arteries thanks to the bulging technique 19 even in the case of a saccular branch. 20 While one stent is often sufficient to transform a wide neck into a small neck aneurysm, a 2 stents technique can sometimes be necessary. Indeed, 2 stents without flowdiversion effect can be used to reconstruct a wide-neck aneurysm with T or Y configurations 21 with excellent occlusion rates at the expense of higher procedural morbidity, however.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of the pCONus device for the treatment of wide-neck bifurcation aneurysms

et al. 2021

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Purpose Wide-neck bifurcation aneurysms remain challenging for the neurointerventionist and/or neurosurgeon despite many recent advances. The pCONus (Phenox, Bochum, Germany) is an emerging device for endovascular neck protection, we report the first long-term results of this device. Methods We performed a retrospective analysis of all consecutive intracranial wide-neck bifurcation aneurysms treated with the pCONus. Patients' characteristics were reviewed, procedural complications, angiographic (Roy-Raymond scale) and clinical outcomes were documented. Results Between January 2016 and September 2019, 43 patients (74% female, median age 56 [49–66] years) with 43 wide-neck bifurcation aneurysms (mean width of 6.8 ± 2.1 mm, dome/neck ratio of 1.3 ± 0.2 and neck of 5.2 ± 1.3 mm) were included. A procedural angiographic complication was reported in five patients (12%), no patient presented a post-operative neurological deficit or long-term complication, mortality rate was 0%. At last follow-up (median of 46.5 months [38.3–51.7]), an adequate occlusion (complete and neck remnant) was observed in 37/43 patients (86%) and an aneurysm remnant in 6/43 (14%). Four patients (9%) needed retreatment. No in-stent stenosis or branch occlusion was depicted. Conclusion pCONus device provides a safe and efficient alternative for endovascular wide-neck bifurcation aneurysms management, with long-term stability.

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Stent-assisted coiling of wide-neck bifurcation aneurysms with a branch incorporated in the aneurysm base: long-term follow-up in 49 patients with 53 aneurysms

Abstract: Stent-assisted coiling is safe and effective for the treatment of WNBA with a branch incorporated in the aneurysm base. Despite poor immediate anatomical results, long-term follow-up shows a high rate of progressive thrombosis achieving adequate and stable occlusion in most patients.

Cited by 7 publications

References 24 publications

Five-Years Angiographic Follow-Up of Wide-Neck Intracranial Aneurysms Treated With LEO Plus Stent

Five-Years Angiographic Follow-Up of Wide-Neck Intracranial Aneurysms Treated With LEO Plus Stent

Y-stenting with braided stents for wide-neck intracranial bifurcation aneurysms. A single-center initial experience

Long-term follow-up of the pCONus device for the treatment of wide-neck bifurcation aneurysms

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