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Endovascular treatment of intracranial aneurysms with remodelling using Leo+ stents
Anatol Dowzenko1, Wojciech Czepiel, Przemysław Richter
1Samodzielna Pracownia Zabiegow i Badan Naczyniowych, Instytut Psychiatrii i Neurologii w Warszawa.
Background And Purpose:
Endovascular embolization is an approved method of treatment of cerebral aneurysms. Several difficulties can be caused by wide-neck aneurysms. In these cases vascular remodelling is required. It can be performed with the use of balloons or intracranial stents. This method allows expansion of the therapeutic indications for aneurysm embolization.
Material And Methods:
We present the results of the Leo+ stent implantation with embolization with coils in nine consecutive patients treated between May 2007 and September 2008 in the Institute of Psychiatry and Neurology.
Results:
In 3 cases embolization was complete, in 4 subtotal, and in 2 partial. In 3 cases the procedure was complicated by stroke: in 2 patients directly after the procedure and in 1 patient 45 days after embolization. 1 patient died due to a recurrent stroke over 1 year after the procedure. Technical failure was noted in 1 patient (stent misplacement from target vessel - the middle cerebral artery to the internal carotid artery, and therefore it did not cover the neck of the aneurysm).
Conclusions:
Vascular remodelling with intracranial stents in treating wide-neck intracranial aneurysms is a promising method allowing the indications for endovascular embolization to be increased. Nevertheless, it seems to carry a relatively high risk of cerebrovascular thromboembolic complications, especially ischaemic stroke. It also seems that the procedure itself might cause some technical difficulties. The full clinical safety and efficacy need further evaluation.
