Beneficial remodeling of small saccular intracranial aneurysms after staged stent only treatment: a case series.

ABSTRACT

BACKGROUND: We evaluated the effect of stent alone treatment for small intracranial aneurysms that were not amenable to coil embolization without prior stent reconstruction. METHODS: This case series was conducted in the neurosurgical service at a tertiary care hospital in Denver, Colorado. Nine patients were electively treated for intracranial aneurysms. All patients had a single low porosity stent reconstruction device placed across the neck of a small intracranial aneurysm. The main outcome measures were changes in aneurysm size and parent vessel morphology during follow-up. RESULTS: Nine patients underwent stent alone treatment for unruptured intracranial aneurysms. The mean follow-up period was 9.6 months (range 6-17 months). There were no cases of periprocedural morbidity or aneurysm rupture during follow-up. All aneurysms decreased in size, and 3 of 9 aneurysms were gone at follow-up. In addition, at follow-up all parent vessels demonstrated straightening about the aneurysm site. CONCLUSIONS: Beneficial remodeling with a decrease in the size of small intracranial aneurysms may be seen after treatment with a single stent alone, particularly if the aneurysm arises at an arterial bend or bifurcation. This phenomenon may be related to a degree of straightening of the parent artery, improving hemodynamic conditions about the aneurysm site.