BACKGROUND AND PURPOSE: Currently available stents for intracranial use usually are balloon-expandable coronary stents that carry the risk of damaging a @entity1347 , with potential vessel rupture. We assessed the technical feasibility and efficacy of the combined application of a flexible, self-expanding neurovascular stent and detachable coils in the management of wide-necked @entity438 in @entity1 . METHODS: Four consecutive @entity1 with a wide-necked @entity438 were treated with a combined approach that consisted of delivery of a flexible self-expanding neurovascular stent through a microcather to cover the neck of the @entity439 and subsequent filling of the @entity439 with coils through the stent interstices. The @entity439 were located at the internal carotid artery (n=2) and the basilar tip encroaching the P1 segment (n=2). Previous attempts with conventional endosaccular coil packing alone failed in all cases. RESULTS: Stent placement in the desired position with complete or nearly complete occlusion of the @entity439 was feasible in all @entity1 . In one @entity1 , @entity439 perforation with the microcatheter occurred and necessitated ventricular drainage, which led to a large parenchymal and @entity548 because of the strong anticoagulation regimen. Six-month follow-up demonstrated no focal neurologic sequelae in any of the @entity1 , except slight @entity2414 in the @entity1 with @entity548 . CONCLUSION: Preliminary data demonstrate that this extremely flexible stent is technically easy to deploy and can be easily and safely maneuvered through severely tortuous vessels, enabling the treatment of @entity438 . The combination of endovascular reconstruction of the parent vessel with use of a self-expanding stent followed by coil embolization offers a promising therapeutic alternative for wide-necked @entity439 not amenable to coil embolization alone. Although immediate angiographic results are promising, long-term angiographic and clinical follow-up is essential to determine permanent vessel patency and @entity439 rate.

Treatment of wide-necked XXXX with a self-expanding stent system: initial clinical experience.

@entity1 :: ('9606', 'Species') :: ['humans', 'patients', 'patient'] @entity548 :: ('MESH:D006470', 'Disease') :: ['intraventricular hemorrhage', 'bleeding'] @entity1347 :: ('MESH:C537775', 'Disease') :: ['dysplastic segment of the artery'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms', 'aneurysm', 'aneurysm occlusion'] @entity2414 :: ('MESH:D008569', 'Disease') :: ['memory dysfunction'] @entity438 :: ('MESH:D002532', 'Disease') :: ['intracranial aneurysm', 'intracranial wide-necked aneurysms', 'intracranial aneurysms']
@entity438 :: (MESH:D002532,Disease) :: ['intracranial aneurysms']
