Application Of Endovascular Stent Graft To Treating Intracranial Aneurysms

1. Purpose:To discuss and summarize the characteristics of intracranial stents used in the clinic currently and notes of application as well as systematize and theorize them to provide theoretical support for clinical work in the future.2. Methods:This paper reviews the clinical data of application of227intracranial stents in process of treatment from October,2003to November,2013at our hospital center, and makes an analysis and summary of the data. Meanwhile, this paper makes an analysis and summary of information related to LEO stents, Neuroform stent, Enterprise stent and Solitaire AB stent, discusses the related technologies of stents used in process of treatment and makes the classification according to the types of application stents, perform statistical analysis on these situations in process of various types of tenting, such as stent placement, displacement after deploying, collapse, thrombogenesis, postoperative recurrence and others. The data has been processed with Stata statistical software.3.ResuIts:The211aneurysms take the embolization therapeutic for184patients in the group. The227intracranial stents are used, including LEO39stent cases, Neuroform51stent cases, Enterprise62stent cases and Solitaire AB75stent cases. The statistical analysis shows the Enterprise stent has optimum flexibility in intraoperative operating followed by Solitaire AB and Neuroform stents. There is no significant difference between Solitaire AB and Neuroform stents. LEO stent is worse than the above three stents, among which radial strength of Enterprise stent is poor and the remaining three stents have no statistically significant difference. The incidence rate of stent displacement is lowest in Solitaire AB stenting. The situations of thrombosis after surgery are respectively that the thrombosis of LEO and Solitaire AB stents is the highest and the remaining two stents have no significant difference. For above four stentings, the aneurysm rupture and recurrence rate within half a year after treatment of intracranial aneurysm have no significant difference. However, the recurrence rate of single-layer tent-assisted coil embolization pseudoaneurysm and dissecting aneurysm was significantly higher than one of the multilayer stents-assisted coil embolization pseudoaneurysm and dissecting aneurysm.4. Conclusion:the application of endovascular stent graft to treating intracranial aneurysms is not only applicable to the wide-neck aneurysm embolization, but also fusiform aneurysms, blood blister-like aneurysm and dissecting aneurysm. The stent-assisted remodeling of the parent artery can not only treat the aneurysm sac, but also protect and repair the diseased arterial wall near the aneurysm neck because of the influence of parent artery and hemodynamic changes within the aneurysm, which can significantly reduce the recurrence rate of the aneurysm. But it is the key to successful treatment to choose different stents and fully understand the characteristics of each stent and method of operation based on the characteristics of each aneurysm and parent artery. The different stents have their own suitable objects, so it should make the personalization options. Multilayer stent should be used for blood blister-like aneurysm and dissecting aneurysm. 1.Purpose:To discuss and summarize the characteristics of intracranial stents used in the clinic currently and notes of application as well as systematize and theorize them to provide theoretical support for clinical work in the future.2.Methods:This paper reviews the clinical data of application of227intracranial stents in process of treatment from October,2003to November,2013at our hospital center, and makes an analysis and summary of the data. Meanwhile, this paper makes an analysis and summary of information related to LEO stents, Neuroform stent, Enterprise stent and Solitaire AB stent, discusses the related technologies of stents used in process of treatment and makes the classification according to the types of application stents, perform statistical analysis on these situations in process of various types of tenting, such as stent placement, displacement after deploying, collapse, thrombogenesis, postoperative recurrence and others. The data has been processed with Stata statistical software.3.The211aneurysms take the embolization therapeutic for184patients in the group. The227intracranial stents are used, including LEO39stent cases, Neuroform51stent cases, Enterprise62stent cases and Solitaire AB75stent cases. The statistical analysis shows the Enterprise stent has optimum flexibility in intraoperative operating followed by Solitaire AB and Neuroform stents. There is no significant difference between Solitaire AB and Neuroform stents. LEO stent is worse than the above three stents, among which radial strength of Enterprise stent is poor and the remaining three stents have no statistically significant difference. The incidence rate of stent displacement is lowest in Solitaire AB stenting. The situations of thrombosis after surgery are respectively that the thrombosis of LEO and Solitaire AB stents is the highest and the remaining two stents have no significant difference. For above four stentings, the aneurysm rupture and recurrence rate within half a year after treatment of intracranial aneurysm have no significant difference. However, the recurrence rate of single-layer tent-assisted coil embolization pseudoaneurysm and dissecting aneurysm was significantly higher than one of the multilayer stents-assisted coil embolization pseudoaneurysm and dissecting aneurysm.4.the application of endovascular stent graft to treating intracranial aneurysms is not only applicable to the wide-neck aneurysm embolization, but also fusiform aneurysms, blood blister-like aneurysm and dissecting aneurysm. The stent-assisted remodeling of the parent artery can not only treat the aneurysm sac, but also protect and repair the diseased arterial wall near the aneurysm neck because of the influence of parent artery and hemodynamic changes within the aneurysm, which can significantly reduce the recurrence rate of the aneurysm. But it is the key to successful treatment to choose different stents and fully understand the characteristics of each stent and method of operation based on the characteristics of each aneurysm and parent artery. The different stents have their own suitable objects, so it should make the personalization options. Multilayer stent should be used for blood blister-like aneurysm and dissecting aneurysm.