PT  - JOURNAL ARTICLE
AU  - Raymond, J.
AU  - Darsaut, T.E.
AU  - Bing, F.
AU  - Makoyeva, A.
AU  - Kotowski, M.
AU  - Gevry, G.
AU  - Salazkin, I.
TI  - Stent-Assisted Coiling of Bifurcation Aneurysms May Improve Endovascular Treatment: A Critical Evaluation in an Experimental Model
AID  - 10.3174/ajnr.A3231
DP  - 2013 Mar 01
TA  - American Journal of Neuroradiology
PG  - 570--576
VI  - 34
IP  - 3
4099  - http://www.ajnr.org/content/34/3/570.short
4100  - http://www.ajnr.org/content/34/3/570.full
SO  - Am. J. Neuroradiol.2013 Mar 01; 34
AB  - BACKGROUND AND PURPOSE: Endovascular treatment of wide-neck bifurcation aneurysms often results in incomplete occlusion or aneurysm recurrence. The goals of this study were to compare results of coil embolization with or without the assistance of self-expandable stents and to examine how stents may influence neointima formation. MATERIALS AND METHODS: Wide-neck bifurcation aneurysms were constructed in 24 animals and, after 4–6 weeks, were randomly allocated to 1 of 5 groups: 1) coil embolization using the assistance of 1 braided stent (n = 5); 2) coil embolization using the assistance of 2 braided stents in a Y configuration (n = 5); 3) coil embolization without stent assistance (n = 6); 4) Y-stenting alone (n = 4); and 5) untreated controls (n = 4). Angiographic results were compared at baseline and at 12 weeks, by using an ordinal scale. Neointima formation at the neck at 12 weeks was compared among groups by using a semiquantitative grading scale. Bench studies were performed to assess stent porosities. RESULTS: Initial angiographic results were improved with single stent–assisted coiling compared with simple coiling (P = .013). Angiographic results at 12 weeks were improved with any stent assistance (P = .014). Neointimal closure of the aneurysm neck was similar with or without stent assistance (P = .908), with neointima covering coil loops but rarely stent struts. Y-stent placement alone had no therapeutic effect. Bench studies showed that porosities can be decreased with stent compaction, but a relatively stable porous transition zone was a limiting factor. CONCLUSIONS: Stent-assisted coiling may improve results of embolization by allowing more complete initial coiling, but these high-porosity stents did not provide a scaffold for more complete neointimal closure of aneurysms.