Additional Embolization for Intra-aneurysmal Blood Flow Resumption after Stent-assisted Embolization of Cerebral Aneurysms

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  • Kajiwara Sosho
    Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
  • Hirohata Masaru
    Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
  • Takeuchi Yasuharu
    Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
  • Fujimura Naoko
    Department of Neurosurgery, Fukuokaken Saiseikai Futsukaichi Hospital, Chikushino, Fukuoka, Japan
  • Yamashita Shin
    Department of Neurosurgery, Omuta City Hospital, Omuta, Fukuoka, Japan
  • Nakamura Yukihiko
    Department of Neurosurgery, Saiseikai Fukuoka General Hospital, Fukuoka, Fukuoka, Japan
  • Hashimoto Aya
    Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
  • Morioka Motohiro
    Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan

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<p>Objective: Stent-assisted aneurysmal embolization (SAAE) is an effective treatment for aneurysms with a low risk of recurrence. In rare cases, retreatment is necessary due to recanalization of blood flow into the aneurysm. However, only a few studies have reported on retreatment. We examined the efficacy and complications of stent-assisted aneurysm embolization for large or wide-neck aneurysms at our hospital.</p><p>Methods: Between July 2010 and June 2018, 293 patients underwent stent-assisted aneurysm embolization at our hospital. Among them, 12 (2 women, 10 men, mean age: 62 years) needed retreatment. We evaluated the initial treatment of these 12 patients, and the methods and results of their retreatment.</p><p>Results: Six of the 12 retreated patients were treated using the simple technique. It was possible to treat nine patients (75%) without placing new stents, but three needed additional stents. We were able to guide the microcatheter into the aneurysm using the trans-cell technique even with two overlapping stents. We achieved complete embolism in seven patients (58%), and remnants were observed in the neck in five (42%) patients. No complications were associated with our surgery. We were able to perform follow-up for 10 patients and there was no recurrence.</p><p>Conclusion: Embolization should be considered in recurrent cases after the initial stent-assisted coil embolization. We achieved good results and reduced the recurrence rate by selecting the appropriate treatment in each case.</p>

収録刊行物

  • 脳神経血管内治療

    脳神経血管内治療 14 (7), 249-254, 2020

    特定非営利活動法人 日本脳神経血管内治療学会

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