Application of the Willis Covered Stent in the Treatment of Ophthalmic Artery Segment Aneurysms: A Single-Center Experience

Liu, Lun-Xin; Zhang, Changwei; Lin, Sen; Wu, Cong; Wang, Ting; Zhou, Liangxue; Xie, Xiaohua

doi:10.1016/j.wneu.2018.10.098

Cited by 8 publications

(16 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…27,28 Hence, some authors have proposed the sacrifice of OA if needed. 29 In this study, 9 cases showed OA occlusion after WCS implantation. Totally 6 patients with vision loss after severe trauma had no changes after the procedure.…”

Section: Limitations Of the Wcs Occlusion Of Side Branchesmentioning

confidence: 56%

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

Lu¹,

Ma²,

Zhu³

et al. 2022

NDT

View full text Add to dashboard Cite

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.

show abstract

Section: Limitations Of the Wcs Occlusion Of Side Branchesmentioning

confidence: 56%

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

Lu¹,

Ma²,

Zhu³

et al. 2022

NDT

View full text Add to dashboard Cite

show abstract

“…As for the choice of stent diameter, endoleak is another major concern, although it is more likely to happen in an application for giant aneurysms ( 8 , 10 , 28 ). Endoleak issues may include stent shrinkage, inappropriate choice of stent, and irregular appearance of the parent artery.…”

Section: Discussionmentioning

confidence: 99%

“…The WCS deployment has unique advantages compared with other treatments. It can isolate aneurysm and reconstruct the parent artery instantly without manipulations in the aneurysm ( 8 ). Several retrospective studies have evaluated the effectiveness of WCSs for BBAs with promising results ( 3 , 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Application of the Willis Covered Stent in the Treatment of Blood Blister-Like Aneurysms: A Single-Center Experience

Fang

Liu

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

ObjectiveTo evaluate the effectiveness of the Willis covered stent (WCS) in the treatment of ruptured blood blister-like aneurysms (BBAs) of the internal carotid artery (ICA).MethodThe clinical data of 16 patients consecutively treated with WCSs from December 2015 to January 2019 were retrospectively analyzed. Clinical data and angiographic findings were analyzed by two experienced neuroradiologists and neurosurgeons, including age, sex, Hunt and Hess (H&H) grade at admission, modified Rankin scale (mRS) score, aneurysm size, and location, the diameter of the patent artery in proximal and distal ends, stent size, rate of aneurysm occlusion, procedure-related complications, and follow-up.ResultsAll the 16 patients (five males, 11 females) with ICA BBAs underwent WCS deployment successfully. The median age was 49 years (range, 29–72). All patients had complete aneurysm occlusion on immediate postoperative angiography. Anterior choroidal artery (AChA) was occluded in one patient accidentally while no obvious neurological dysfunction was observed. However, this patient underwent subarachnoid hemorrhage 1 day after the treatment; endoleak and aneurysm recurred, and the patient died 10 days later. Therefore, the effective rate of WCS treatment was 93.8% (15/16), and procedure-related complications rate was 6.3% (1/16). Moreover, one patient was urgently treated because of accidental aneurysm rupture after anesthesia, and external ventricular drainage was then performed postoperatively. Another patient developed coma and hemiplegia 3 days after treatment, with emergency angiography showing in-stent thrombosis and ICA occlusion which was recanalized with arterial rt-PA thrombolysis; the patient recovered completely. The clinical follow-up period was 3–30 months in 14 patients. The mRS scores were 0 in 12 patients (85.7%) and 4 in 1 case (7.1%), while 1 patient (7.1%) died 6 months postoperatively for unknown reasons. Angiographic follow-up was performed in 13 patients, and no recurrence was observed. However, ICA occlusion without neurological deficit was observed in one patient.ConclusionBased on careful preoperative evaluation, appropriate WCS size selection, and precise surgical operation, WCSs may provide an alternative and effective solution for blood BBAs via aneurysm isolation and ICA reconstruction immediately; However, further follow-up studies with larger samples are required.

show abstract

“…In the report by Yan et al ( 64) of 49 intracranial aneurysms, 77.6% of aneurysms were large and located at the paraophthalmic segment; after covered stent (MicroPort, Shanghai, China) deployment, complete occlusion was achieved in 89.5% of aneurysms. However, stiff-covered stents have difficulty navigating through the ICA siphon, and procedure-related complications are non-negligible, including stent navigation failure, vasospasm, acute in-stent thrombosis, endoleak, and OphA, PcomA, or anterior choroidal artery occlusion (65,66).…”

Section: Covered Stent Placementmentioning

confidence: 99%

“…The postoperative double-antiplatelet regimen should continue for 6 months, and then a single-antiplatelet regimen (100 mg aspirin) should be continued for life (64). Currently, an FDS can replace a covered stent in most aneurysms of the paraophthalmic segment with fewer complications, especially when the side branches can be preserved (66).…”

Section: Covered Stent Placementmentioning

confidence: 99%

Endovascular treatment of aneurysms of the paraophthalmic segment of the internal carotid artery: Current status

Wang

2022

Front. Neurol.

View full text Add to dashboard Cite

The paraophthalmic segment of the internal carotid artery (ICA) originates from the distal border of the cavernous ICA and terminates at the posterior communicating artery. Aneurysms arising from the paraophthalmic segment represent ~5–10% of intradural aneurysms. Due to the advent of endovascular treatment (EVT) techniques, specifically flow-diverting stents (FDSs), EVT has become a good option for these aneurysms. A literature review on EVT for paraophthalmic segment aneurysms is necessary. In this review, we discuss the anatomy of the paraophthalmic segment, classification of the paraophthalmic segment aneurysms, EVT principle and techniques, and prognosis and complications. EVT techniques for paraophthalmic segment aneurysms include coil embolization, FDSs, covered stents, and Woven EndoBridge devices. Currently, coiling embolization remains the best choice for ruptured paraophthalmic segment aneurysms, especially to avoid long-term antiplatelet therapy for young patients. Due to the excessive use of antiplatelet therapy, unruptured paraophthalmic segment aneurysms that are easy to coil should not be treated with FDS. FDS is appropriate for uncoilable or failed aneurysms. Other devices cannot act as the primary choice but can be useful auxiliary tools. Both coiling embolization and FDS deployment can result in a good prognosis for paraophthalmic segment aneurysms. The overall complication rate is low. Therefore, EVT offers promising treatments for paraophthalmic segment aneurysms. In addition, surgical clipping continues to be a good choice for paraophthalmic segment aneurysms in the endovascular era.

show abstract

Application of the Willis Covered Stent in the Treatment of Ophthalmic Artery Segment Aneurysms: A Single-Center Experience

Cited by 8 publications

References 18 publications

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

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

Application of the Willis Covered Stent in the Treatment of Blood Blister-Like Aneurysms: A Single-Center Experience

Endovascular treatment of aneurysms of the paraophthalmic segment of the internal carotid artery: Current status

Contact Info

Product

Resources

About