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Stent-assisted coil embolization for cavernous carotid artery aneurysms.
Kenichi Kono1, Aki Shintani, Hideo Okada
1Department of Neurosurgery, Wakayama Rosai Hospital.
Neurologia Medico-Chirurgica
|November 22, 2013
Summary
Stent-assisted coil embolization (SACE) offers a promising treatment for cavernous sinus (CS) aneurysms, potentially reducing retreatment needs and improving cranial nerve (CN) dysfunction. This technique shows good mid-term results in selected patients.
Area of Science:
- Neurosurgery
- Interventional Neuroradiology
- Vascular Neurology
Background:
- Traditional treatments for cavernous sinus (CS) aneurysms, such as internal carotid artery (ICA) occlusion, have limitations.
- Coil embolization alone often requires retreatment due to the large size of CS aneurysms.
Observation:
- This study reports mid-term outcomes for six unruptured CS aneurysms treated with stent-assisted coil embolization (SACE).
- Patients had a mean age of 72 years, with aneurysms averaging 19.8 mm.
- Four patients presented with cranial nerve (CN) dysfunction; two were asymptomatic.
Findings:
- SACE achieved tight packing (mean 29.1%) with no neurological complications.
- CN dysfunction resolved in 75% and partly in 25% of affected patients.
- Recanalization occurred in 50% of cases, but no retreatment was necessary during the 6-26 month follow-up.
Implications:
- SACE enhances packing density and may decrease retreatment rates for CS aneurysms.
- It presents a potentially superior alternative to coil embolization alone and a viable option to ICA occlusion for specific patient groups.
- Consider SACE for elderly patients or those unsuitable for general anesthesia or high-flow bypass surgery.
