Delayed Thrombosis or Stenosis Following Enterprise-Assisted Stent-Coiling: Is It Safe? Midterm Results of the Interstate Collaboration of Enterprise Stent Coiling

Author:

Mocco J1,Fargen Kyle M1,Albuquerque Felipe C2,Bendok Bernard R3,Boulos Alan S4,Carpenter Jeffrey S5,Fiorella David J6,Hoh Brian L1,Howington Jay U7,Liebman Kenneth M8,Natarajan Sabareesh K9,Rai Ansaar T5,Rodriguez-Mercado Rafael10,Siddiqui Adnan H9,Snyder Kenneth V9,Veznedaroglu Erol8,Hopkins L Nelson9,Levy Elad I9

Affiliation:

1. Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida

2. Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona

3. Departments of Neurological Surgery and Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois

4. Division of Neurosurgery, Albany Medical Center Hospital, Albany, New York

5. Interventional Neuroradiology, Department of Radiology, West Virginia University School of Medicine, Morgantown, West Virginia

6. Departments of Neurosurgery and Neuroradiology, State University of New York at Stony Brook, New York

7. Neurological Institute of Savannah, Savannah, Georgia

8. ‡Department of Neurological Surgery, New Jersey Capital Health System, Trenton, New Jersey

9. §Departments of Neurosurgery and Radiology, and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York at Buffalo, Buffalo, New York

10. ‖Department of Neurosurgery, University of Puerto Rico, San Juan, Puerto Rico

Abstract

Abstract BACKGROUND: Stent-assisted coiling of intracranial aneurysms with self-expanding stents has widened the applicability of neuroendovascular therapies to those aneurysms previously considered “uncoilable” because of poor morphology. The Enterprise Vascular Reconstruction Device and Delivery System (Cordis) has demonstrated promising initial short-term results. However, the rates of delayed in-stent stenosis or thrombosis are not known. OBJECTIVE: To report midterm results of the Enterprise stent system. METHODS: A 10-center registry was created to provide a large volume of data on the safety and efficacy of the Enterprise stent system. Pooled data were compiled for consecutive patients undergoing Enterprise stent-assisted coiling at each institution. Available follow-up data were evaluated for the incidence of in-stent stenosis, thrombosis, and aneurysm occlusion. RESULTS: In total, 213 patients (176 females) with 219 aneurysms were treated with the Enterprise stent. One hundred ten patients had undergone delayed angiography (≥30 days from stent placement, mean follow-up 174.6 days). Forty percent of patients demonstrated total occlusion with 88% having ≥90% aneurysm occlusion. Six percent of patients had delayed (>30 days) angiographic findings, of which 3% demonstrated significant (≥50%) in-stent stenosis or occlusion. Seven delayed thrombotic events occurred (3%), along with 2 additional immediate periprocedural events. All 7 delayed events were concomitant to cessation of double-antiplatelet therapy. CONCLUSION: Midterm occlusion rates are excellent, and stenosis and thrombosis rates are comparable to other available neurovascular stents. Interruption of antiplatelet therapy appears to be a factor in those developing delayed stenosis or thrombosis.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Clinical Neurology,Surgery

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3