Semi-Jailing Technique Using a Neuroform3 Stent for Coiling of Wide-Necked Intracranial Aneurysms

摘要

Objective The semi-jailing technique (SJT) provides stent-assisted remodeling of the aneurysm neck during coil embolization without grasping the coil delivery microcatheter. We retrospectively evaluated the efficacy and safety of SJT using a Neuroform3 stent for coiling of wide-necked intracranial aneurysms. Methods We collected the clinical and radiological data between January 2009 and June 2015 of the wide-necked aneurysms treated with SJT using a Neuroform3 stent. Results SJT using a Neuroform3 stent was attempted in 70 wide-necked aneurysms (68 patients). There were 56 unruptured and 14 ruptured aneurysms. The size of aneurysm ranged from 1.7 to 28.1 mm (mean 6.1 mm). The immediate angiographic results were complete occlusion in 55 aneurysms (78.6%), neck remnant in 7 (10.0%), and aneurysm remnant in 8 (11.4%). Overall, periprocedural complications occurred in 13 patients (19.1%), including asymptomatic thromboembolism in 7 (10.3%), symptomatic thromboembolism in 4 (5.9%), and symptomatic hemorrhagic complications in 2 (2.9%). Conventional angiography follow-up was obtained in 55 (78.6%) of 70 aneurysms (mean, 10.9 months). The result showed progressive occlusion in 7 aneurysms (12.7%) and recanalization in 1 aneurysm (1.8%). At the end of the observation period (mean, 17.5 months), all 54 patients without subarachnoid hemorrhage showed excellent clinical outcomes (modified Rankin Scale [mRS] 0), except two (mRS 1 or 2) and seven of 14 patients with subarachnoid hemorrhage remained symptom-free (mRS 0). Conclusion In this report of 70 aneurysms, SJT using a Neuroform3 stent for coiling of wide-necked intracranial aneurysms showed good technical safety, as well as favorable clinical and angiographic outcomes. Keywords: Aneurysm, Coil, Stent