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01.01.2013 | Vascular-Interventional

Frequency and predictors of endoleaks and long-term patency after covered stent placement for the treatment of intracranial aneurysms: a prospective, non-randomised multicentre experience

verfasst von: Yue-Qi Zhu, Ming-Hua Li, Feng Lin, Dong-Lei Song, Hua-Qiao Tan, Bin-Xian Gu, Hong-Qi Zhang, Bin Leng, Pei-Lei Zhang

Erschienen in: European Radiology | Ausgabe 1/2013

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Abstract

Objective

We investigated immediate/late endoleaks and long-term patency following stent-graft placement for treatment of intracranial aneurysms located within the distal internal carotid artery (ICA) or vertebral artery (VA).

Methods

Forty-five aneurysms in 41 patients receiving covered stents in three centres were followed. Outcome measures included aneurysm occlusion rate, endoleaks, late in-stent stenosis rate, clinical improvement, neurological deficiencies and death.

Results

Total aneurysm exclusion was achieved in 69.2% (n = 27), with 30.8% (n = 12) experiencing immediate residual endoleaks. Angiographic follow-up (mean 43.5 ± 14.3 months) revealed that 87.2% (n = 34) were completely occluded with only 12.8% (n = 5) showing residual endoleaks. Predictors of immediate endoleaks in our patient group were stent number (P = 0.023) and stent diameter (P = 0.022), while predictors of late endoleaks in our patient group were stent diameter (P = 0.035) and stent angulation (P = 0.021). Late in-stent stenosis rates were 18.0 ± 13.3 and 29.0 ± 18.5% compared with the period immediately following implantation at 2- and 6-year follow-ups respectively. Smoking (P = 0.017) and stent angulation (P = 0.020) were predictors of late in-stent stenosis.

Conclusion

Treating intracranial aneurysms with Willis stent-grafts has an acceptable immediate and late occlusion rate and long-term stented artery patency rate.

Key Points

• Covered stents can be a treatment option for intracranial aneurysms.

• Technical success for treating distal ICA and VA aneurysms can reach 97.6%.

• However immediate and late endoleaks occur in 30.8 and 12.8% respectively.

• The number, diameter and angulation of stents are possible predictors of endoleaks.

• Smoking and stent angulation seem to predict late in-stent stenosis.

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Titel: Frequency and predictors of endoleaks and long-term patency after covered stent placement for the treatment of intracranial aneurysms: a prospective, non-randomised multicentre experience
verfasst von: Yue-Qi Zhu
Ming-Hua Li
Feng Lin
Dong-Lei Song
Hua-Qiao Tan
Bin-Xian Gu
Hong-Qi Zhang
Bin Leng
Pei-Lei Zhang
Publikationsdatum: 01.01.2013
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 1/2013
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2581-4

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Frequency and predictors of endoleaks and long-term patency after covered stent placement for the treatment of intracranial aneurysms: a prospective, non-randomised multicentre experience