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Stent-assisted coil emboilization of ruptured intracranial aneurysms: A retrospective multicenter review.

Publication ,  Journal Article
Golshani, K; Ferrel, A; Lessne, M; Shah, P; Chowdhary, A; Choulakian, A; Alexander, MJ; Smith, TP; Enterline, DS; Zomorodi, AR; Britz, GW
Published in: Surg Neurol Int
2012

BACKGROUND: The purpose of this study is to retrospectively review our experience with stent-assisted embolization of patients with an acutely ruptured cerebral aneurysm. METHODS: Medical records and imaging were reviewed for 36 patients who underwent stent-assisted embolization of a ruptured cerebral aneurysm. RESULTS: Seventeen patients (47%) received a preprocedural loading dose of clopidogrel and five patients (14%) received an intraprocedural dose of clopidogrel. The remaining 14 patients (36%) were treated with antiplatelet therapy following the procedure. Six (17%) stent related intraprocedural thromboembolic complications were encountered; four of these resolved (one partial, three complete) following treatment with abciximab and/or heparin during the procedure. Five of the six thromboembolic events occurred in patients who were not pretreated with clopidogrel (P = 0.043). Two patients in this series (6%) had a permanent thrombotic complication resulting in mild hemiparesis in one patient, and hemianopsia in the second. No procedure related hemorrhagic complications occurred in any patient. One patient had a spontaneous parenchymal hemorrhage contralateral to the treated aneurysm discovered 10 days after treatment. Twenty-eight patients (78%) had a Glasgow Outcome Score of 4 or better at discharge. Seven of 21 patients (33%) with angiographic follow-up required further treatment of the coiled aneurysm. CONCLUSION: Stent-assisted coil embolization is an option for treatment of ruptured wide neck ruptured aneurysms and for salvage treatment during unassisted embolization of ruptured aneurysms but complications and retreatment rates are higher than for routine clipping or coiling of cerebral aneurysms. Pretreatment with clopidogrel appears effective in reducing thrombotic complications without significant increasing risk of hemorrhagic complications.

Duke Scholars

Published In

Surg Neurol Int

DOI

EISSN

2152-7806

Publication Date

2012

Volume

3

Start / End Page

84

Location

United States

Related Subject Headings

  • 5202 Biological psychology
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Golshani, K., Ferrel, A., Lessne, M., Shah, P., Chowdhary, A., Choulakian, A., … Britz, G. W. (2012). Stent-assisted coil emboilization of ruptured intracranial aneurysms: A retrospective multicenter review. Surg Neurol Int, 3, 84. https://doi.org/10.4103/2152-7806.99174
Golshani, Kiarash, Andrew Ferrel, Mark Lessne, Pratish Shah, Abhineet Chowdhary, Armen Choulakian, Michael J. Alexander, et al. “Stent-assisted coil emboilization of ruptured intracranial aneurysms: A retrospective multicenter review.Surg Neurol Int 3 (2012): 84. https://doi.org/10.4103/2152-7806.99174.
Golshani K, Ferrel A, Lessne M, Shah P, Chowdhary A, Choulakian A, et al. Stent-assisted coil emboilization of ruptured intracranial aneurysms: A retrospective multicenter review. Surg Neurol Int. 2012;3:84.
Golshani, Kiarash, et al. “Stent-assisted coil emboilization of ruptured intracranial aneurysms: A retrospective multicenter review.Surg Neurol Int, vol. 3, 2012, p. 84. Pubmed, doi:10.4103/2152-7806.99174.
Golshani K, Ferrel A, Lessne M, Shah P, Chowdhary A, Choulakian A, Alexander MJ, Smith TP, Enterline DS, Zomorodi AR, Britz GW. Stent-assisted coil emboilization of ruptured intracranial aneurysms: A retrospective multicenter review. Surg Neurol Int. 2012;3:84.

Published In

Surg Neurol Int

DOI

EISSN

2152-7806

Publication Date

2012

Volume

3

Start / End Page

84

Location

United States

Related Subject Headings

  • 5202 Biological psychology
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences