Multiple overlapping stent-assisted coiling of complex aneurysms: a single-center experience

Area of Science:

• Neurosurgery
• Interventional Radiology
• Vascular Neurology

Background:

• Coil embolization of complex brain aneurysms, including wide-necked and fusiform types, presents significant challenges.
• Recanalization remains a common issue despite the use of additional devices during embolization.

Purpose of the Study:

• To evaluate the feasibility and mid-term outcomes of using multiple overlapping stent-assisted coiling (OSAC) for complex aneurysms.
• To assess the efficacy of OSAC in preventing recanalization and improving aneurysm stability.

Main Methods:

• A retrospective analysis of 26 patients with wide-necked and fusiform aneurysms treated with multiple OSAC.
• Evaluation of immediate procedural complications and angiographic follow-up data.

Main Results:

• Complete embolization was achieved in 57.7% of aneurysms; remnant neck or aneurysm was noted in 42.3%.
• Immediate complications occurred in 19.2%, with permanent neurologic deficits in 7.7%.
• At a mean follow-up of 23.9 months, 61.1% of treated aneurysms remained stable, with one major recanalization (5.5%). Recurrent or recanalized aneurysms re-treated with additional OSAC showed no further recanalization.

Conclusions:

• Multiple OSAC is a feasible and effective treatment strategy for complex brain aneurysms.
• This technique demonstrates good mid-term durability and is effective for managing recurrent aneurysms post-stent-assisted coiling.