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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Willis Covered Stent for Treating Intracranial Pseudoaneurysms of the Internal Carotid Artery: A Multi-Institutional
1Department of Neurosurgery, Xi'an International Medical Center Hospital, Xi'an, People's Republic of China.
Insights
Willis covered stents (WCS) effectively treat intracranial pseudoaneurysms (PSAs) in the internal carotid artery (ICA), showing high occlusion rates. Irregular antiplatelet therapy and specific ICA segments were linked to in-stent stenosis.
Area of Science:
- Interventional neuroradiology
- Vascular surgery
- Neurology
Background:
- Intracranial pseudoaneurysms (PSAs) of the internal carotid artery (ICA) pose significant risks.
- Effective treatment options for these complex lesions are crucial.
Purpose of the Study:
- To evaluate the therapeutic efficacy of Willis covered stents (WCS) for treating intracranial PSAs of the ICA.
- To identify potential risk factors for complications after WCS implantation.
Main Methods:
- Retrospective analysis of 56 patients with intracranial PSAs of the ICA treated with WCS across three centers (June 2018 - July 2021).
- Data collected included medical records, operative parameters, imaging findings, and follow-up data.
- Assessment of procedural success, aneurysm occlusion, and in-stent stenosis.
Main Results:
- Successful WCS implantation in all cases.
- 94.6% total PSA exclusion immediately post-procedure.
- 100% aneurysm occlusion at follow-up, including cases with initial endoleak.
- In-stent stenosis observed in 12.5% of patients.
- Irregular antiplatelet treatment and ICA C4-C5 segment involvement predicted late in-stent stenosis.
Conclusions:
- Willis covered stents (WCS) demonstrate high efficacy and safety in treating intracranial pseudoaneurysms (PSAs) of the internal carotid artery (ICA).
- Close monitoring for in-stent stenosis and adherence to antiplatelet therapy are recommended post-procedure.
Objective:
This work aimed to retrospectively analyze Willis covered stent (WCS)'s therapeutic efficacy in intracranial pseudoaneurysms (PSAs) of the internal carotid artery (ICA).
Methods:
Between June 2018 and July 2021, 56 individuals with intracranial PSAs of the ICA treated with WCS in three centers were included to analyze information regarding medical records, operative parameters, imaging findings and follow-up data.
Results:
All WCSs were successfully targeted to the ICA lesions. Total exclusion of PSA was found in 53 cases (94.6%) right upon surgery, and mild endoleak into the aneurysm remained in 3 cases (5.4%). Intraoperative thrombosis occurred in 1 case (1.8%), and tirofiban was utilized for recanalization. Follow-up by angiography showed total aneurysm occlusion in the total number of individuals, including in the 3 above cases with residual endoleak. In-stent stenosis occurred in 7 (12.5%) patients. No stent-related ischemic event was encountered. Predictive factors of late in-stent stenosis following WCS implantation in this patient group were irregular post-operative antiplatelet treatment (p = 0.015) and C4-C5 segment of the ICA (p = 0.043).
Conclusion:
WCSs are effective in treating intracranial PSAs of the ICA.
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