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Stent-assisted coiling of wide-necked intracranial aneurysms using the Solitaire AB stent
Vikram Huded1, Rithesh R Nair1, Devashish D Vyas2
1Division of Interventional Neurology and Stroke, Narayana Health Institute of Neurosciences, Bangalore, Karnataka, India.
Context:
Stent-assisted coiling of wide-necked and complex intracranial aneurysms is an effective and feasible treatment option. The self-expanding, fully retrievable Solitaire AB (eV3, Irvine, CA, USA) stent is the latest neurovascular remodeling device available. To the best of our knowledge, there are no studies of Solitaire AB-assisted coiling of wide-necked intracranial aneurysms from India.
Aim:
Solitaire AB-assisted coiling of wide-necked intracranial aneurysms.
Materials And Methods:
The study was conducted in a tertiary care center with a dedicated Interventional Neurology division from 2009 to 2013. Consecutive patients with wide-necked aneurysms who underwent coiling assisted by the Solitaire AB stent were enrolled in the study. Axium 3D and Helix (eV3, Irvine, CA, USA) platinum coils were used to densely pack the aneurysm sac after deploying the stent across the neck. All patients were pretreated with antiplatelets according to protocol. Subsequently, dual antiplatelets were given for 6 months followed by continued aspirin. Outcome was assessed at 3 months using the modified Rankin Scale.
Statistical Analysis Used:
Statistical analysis was done using the SPSS 17.0 software.
Results:
A total of 16 patients underwent stent-assisted coiling. The most common site was the internal carotid artery (nine patients), median aneurysm size was 7 mm and median neck diameter was 5 mm. Thirteen patients presented with ruptured aneurysms. We achieved complete occlusion in all patients with no major complications. Thirteen patients were followed up, all have an mRS score of zero or one.
Conclusion:
We conclude that for wide-necked aneurysms, stent-assisted coiling using the Solitaire AB is a safe and effective treatment option.
