4.4 Article

Braided stents assisted coiling for endovascular management of posterior cerebral artery aneurysms: a preliminary mid-term experience

Journal

NEURORADIOLOGY
Volume 64, Issue 9, Pages 1847-1856

Publisher

SPRINGER
DOI: 10.1007/s00234-022-02956-3

Keywords

Braided stent; Posterior cerebral artery aneurysm; Stent-assisted coiling; Endovascular treatment

Funding

  1. National Key R&D Program of China [2016YFC1300700]
  2. National Natural Science Foundation of China [81771266, 81701136, 81771264]
  3. Shanghai Shenkang Three-year Action Plan Major Clinical Research Project [SHDC2020CR4037]

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This study evaluated the initial experience of braided stents in the treatment of PCA aneurysms. The results showed that braided stent-assisted coiling had a high occlusion rate and relatively low complication rate, providing an alternative strategy for treating PCA aneurysms.
Purpose Posterior cerebral artery (PCA) aneurysms are rare. This study is to evaluate the preliminary experience of braided stents applied in PCA aneurysms treatment. Methods Angiographic and clinical data of 28 PCA patients treated with braided stents from July 2016 and September 2020 were retrospectively analyzed. Results A total of 28 PCA aneurysms were enrolled. 22 (78.6%) aneurysms were dissecting aneurysms, while 6 (21.4%) aneurysms were saccular aneurysms. Thirty-five braided stents were implanted with dual stents implanted in 7 cases. Immediate angiographic results show that Raymond class I was obtained in 13 patients (46.4%), Raymond class II was obtained in 4 patients (14.3%), and Raymond class III was obtained in 11 patients (39.3%). Perioperative hemorrhagic events occurred in 1 patient (3.6%). Twenty-four patients (85.7%) received angiographic follow-up, and the mean follow-up time was 11.2 +/- 4.9 months. Two patients (8.3%) were confirmed with IA neck recurrence, and 3 patients (12.5%) were confirmed asymptomatic parent artery occlusion (PAO). The other 19 patients were confirmed promoted occlusion with 18 Raymond class I (75%) and 1 Raymond class II (4.2%). Twenty-seven patients (96.4%) received clinical follow-up, and the mean follow-up time was 32.2 +/- 13.5 months. One patient (3.7%) confirmed the death event 2 weeks after discharge. The other 27 patients (96.3%) got favorable clinical outcomes with an mRS score of 0-2. Conclusions Braided stent-assisted coiling with a high occlusion rate and relatively low complication rate provides an alternative strategy in treating PCA aneurysms. Long-term outcomes need further randomized study with larger case numbers.

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