• Xu Gao, Guobiao Liang, Youxiang Li, and Zhongxue Wu.
• Beijing Neurosurgical Institute, Capital Medical University, Beijing, People's Republic of China.
• Neurol India. 2010 Nov 1; 58 (6): 825-32.

BackgroundLarge and giant aneurysms still remain a therapeutic challenge both surgically and endovascularly.ObjectiveThe authors report their clinical experience and follow-up results using Neuroform stent, as an adjunct in the treatment of large and giant aneurysms.Materials And MethodsA total of 71 consecutive patients with 72 large or giant intracranial aneurysms were treated with the Neuroform stent-assisted coiling. Both sequential technique and parallel technique were used. In all cases, embolization was completed by packing the aneurysm sac with a variety of commercially available coils. The technical feasibility of the procedure, procedure-related complications, angiographic results, clinical outcome, and follow-up angiography were evaluated.ResultsIn all the patients, the Neuroform stent system was delivered and deployed accurately, and occlusion was achieved. Immediate angiography demonstrated complete occlusion of the aneurysm in 59.7% of the patients, neck remnant in 26.4%, and incomplete occlusion in 13.9%. Procedure-related complication, morbidity, and mortality were 15.3, 4.2, and 1.4%, respectively. Favorable clinical outcome (modified Rankin Scale score 0-2) was observed in 83.3% of the patients (average follow-up time: 37.1 months). None of the treated aneurysm had rebleeding. Angiography follow-up was obtained in 81.7% (58/71 patients; 59/72 aneurysms; average follow-up time, 43.2 months). The overall recanalization rate was 28.8%. No delayed coil or stent migration was found. In-stent stenosis occurred as a delayed complication in one patient.ConclusionsThe Neuroform stent-assisted coiling for large and giant intracranial aneurysms is safe and feasible with comparable incidences of morbidity and mortality.

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