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Research paper
Progressive occlusion of aneurysms in Neuroform Stent-assisted treatment of intracranial aneurysms
  1. A M Yahia1,2,3,
  2. J G Latorre1,
  3. V Gordon5,
  4. J Whapham6,
  5. A Swarnkar3,
  6. R D Fessler4,5
  1. 1Department of Neurology, Upstate Medical University, Syracuse, New York, USA
  2. 2Department of Neurosurgery, Upstate Medical University, Syracuse, New York, USA
  3. 3Department of Radiology, Upstate Medical University, Syracuse, New York, USA
  4. 4Department of Neurosurgery, Wayne State University, Detroit, Michigan, USA
  5. 5Department of Neurosurgery, Providence Main Hospital/St. John Health, Detroit, Michigan, USA
  6. 6Department of Neurosurgery, Loyola University School of Medicine, Illinois, USA
  1. Correspondence to Professor A M Yahia, Upstate Medical University and University Hospital, SUNY, 750 E Adams Street, Syracuse, NY 13210, USA; yahia25{at}hotmail.com

Abstract

Introduction The long term effect of Neuroform stent in progressive occlusion of intracranial aneurysms is not yet completely understood. Here the effect of the Neuroform stent in progressive occlusion of intracranial aneurysms and clinical outcome is reported.

Methods Consecutive patients treated with the Neuroform stent from January 2003 to July 2007 were prospectively enrolled. Patients' demographics, immediate and delayed rate of occlusion, and clinical outcomes using the National Institution of Health Stroke Scale (NIHSS) and the Glasgow Outcome Scale (GOS) were recorded.

Results Neuroform stent placement was attempted in 72 patients, including 10 ruptured cases. However, stent placement could not be accomplished in two patients who were not included for analysis. Mean age was 50±14 years and mean aneurysm diameter was 10.28±5.9 mm. Immediate complete occlusion was observed in 31 (44%), neck remnants in 29 (41%) and subtotal occlusion in 10 (14%). Angiographic follow-up was available in 59 cases; complete occlusion was observed in 48/59 (81%), neck remnant in 7/59 (13%) and recanalisation in 4/49 (7%). Of 39 patients with immediate incomplete obliteration, progressive complete occlusions were achieved in 25/31 (81%), no changes in two and recanalisation in four cases. The majority of patients had good outcomes (GOS 1 or NIHSS 0 in 66/70 (94%), GOS 2 or NIHSS 2 in one patient and GOS 3 or NIHSS 4 in three at the 90 day follow-up visit.

Conclusions The Neuroform stent assisted neck remodelling technique improves progressive obliteration of intracranial aneurysms with a low recanalisation rate and good clinical outcome.

  • CEREBROVASCULAR DISEASE
  • INTERVENTIONAL
  • SUBARACHNOID HAEMORRHAGE

http://dx.doi.org/10.1136/jnnp.2009.173864

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    Footnotes

    • Competing interests None.

    • Ethics approval This study was conducted with the approval of the Providence Hospital, Michigan and Upstate Medical University.

    • Provenance and peer review Not commissioned; externally peer reviewed.