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[Stenting plus coiling: dangerous or helpful?].

I Wanke1, E Gizewski, A Dörfler

  • 1Institut für Radiologie und Neuroradiologie. isabel.wanke@uni-essen.de

Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|August 27, 2005
PubMed
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This study shows that combining stents and platinum coils is a safe and effective option for treating acute ruptured aneurysms, even in complex cases. This endovascular technique achieved high occlusion rates with no neurological complications in nine patients.

Area of Science:

  • Neurosurgery
  • Interventional Neuroradiology
  • Vascular Neurology

Background:

  • Acute ruptured aneurysms pose significant risks.
  • Traditional treatments like clipping may not be suitable for all aneurysm types.
  • Endovascular techniques offer alternative treatment modalities.

Purpose of the Study:

  • To assess the procedural safety and efficacy of stent-coil embolization for acute ruptured aneurysms.
  • To evaluate the risk associated with this combined endovascular approach.

Main Methods:

  • Nine patients with acute subarachnoid hemorrhage (SAH) due to ruptured aneurysms were treated.
  • A combination of neurovascular stents and platinum coils was used for embolization.
  • Management of complications included GP IIa/IIIb-antagonists, intraarterial Nimotop, Aspirin, and Plavix.

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Main Results:

  • Complete elimination of six aneurysms (100% occlusion).
  • 95% to 99% occlusion in the remaining three aneurysms.
  • Transient stent thrombosis and distal vasospasm were successfully managed without neurological deficits.

Conclusions:

  • Stent-coil embolization is a viable option for broad-based aneurysms unsuitable for clipping or high-risk neurosurgical intervention.
  • This technique can be safely applied during the acute phase of SAH.
  • Effective management strategies exist for potential complications like thrombosis and vasospasm.