Complications and Adverse Events Associated with Stent-Assisted Coiling of Wide-Neck Intracranial Aneurysms

Stent-Assisted Endovascular Treatment of Anterior Communicating Artery Aneurysms – Literature Review

“…A self-expandable stent serves as a scaffold which prevents the coil protrusion into the parent artery and results in denser coil packing [ 21 ]. Moreover, a stent may be deployed in case of earlier coil protrusion into the parent vessel as a prevention of a thromboembolic event [ 5 , 17 , 18 , 22 ]. In addition to their mechanical function, stents are reported to have hemodynamic effects as they redirect blood flow from the sac of the aneurysm toward the distal parent artery.…”

“…It is suggested that expected delayed intra-aneurysmal thrombosis should be taken into consideration in case of incomplete immediate stent-assisted embolization and insertion of additional coils is considered risky [ 6 ]. Moreover, stent deployment during intracranial aneurysm coiling is reported to improve the durability of aneurysm embolization probably because of arterial wall reconstruction at the level of the neck, stent endothelialization and change of the hemodynamics [ 17 , 20 , 22 , 32 ]. Nevertheless, as recurrences may still happen, radiographic follow-up is mandatory.…”

“…In a general population of all brain aneurysms treated with stent-assisted coiling the rate is 13–23% [ 13 ]. Recurrences are observed mainly within 6 months after treatment [ 17 ]. Risk factors for cerebral aneurysm recanalization after stented coiling are wide-necked aneurysms, partial occluded aneurysms and large or giant aneurysms [ 17 ].…”

“…Recurrences are observed mainly within 6 months after treatment [ 17 ]. Risk factors for cerebral aneurysm recanalization after stented coiling are wide-necked aneurysms, partial occluded aneurysms and large or giant aneurysms [ 17 ]. Treatment options for residual or recurrent aneurysms after coil embolization include surgical clipping, re-coiling or observation [ 38 ].…”

“…Stent-assisted coil embolization of intracranial aneurysms including AcomA aneurysms is reported to be a safe technique with low morbidity and mortality rates [ 5 , 17 ]. In this group the overall procedure-related complication, morbidity and mortality were 14.2%, 4.2% and 1.3%, respectively [ 17 ]. Morbidity and death rate in case of stent-assisted coiling of AcomA aneurysms is 0–5% [ 5 , 6 , 18 ].…”