Endovascular treatment of intracranial aneurysms with covered stents (with report of 9 cases)

Objective To evaluate the effectiveness and indications of endovascular treatment of intracranial aneurysms with covered stents. Methods During the last 5 years, 9 patients with intracranial aneurysms were selected and treated by endovascular implantation 9 coronary stent grafts (Jostent GraftMaster). The 9 patients were 28-65 years old (average 46). There were 4 cases with internal carotid cavernous wide neck unruptured aneurysms. Among them 3 patients suffered with diplopia whose aneurysmal diameters were 12-16 mm, and the other one suffered with transient ischemic attack (TIA) whose internal carotid cavernous segment stenosis associated with a wide neck aneurysm (diameter 4 mm). Five cases suffered from intracranial vertebral dissecting or fusiform aneurysms with subarachnoid hemorrhage (SAH). The Hunt⁃Hess degrees were Ⅰ-Ⅱ. The aneurysmal diameters were 4-6 mm. Before operation all patients administrated clopidogrel 75 mg and aspirin 300 mg per day at least for 3 d. All patients were treated with Jostent covered stent. Results The stent placement was successful. All covered stents were successfully deployed in the parent artery across the lesions. All aneurysms were excluded immediately. Five of 9 patients (2 carotid and 3 vertebral) were followed by cerebral angiography for 9-24 months after treatment. At stent placement carotid artery blood flow became fluent and no stenosis was seen in 2 cases, vertebral arteries were asymptomatic occluded in 2 cases, and slightly in⁃stent stenosis at vertebral artery was seen in one case. No aneurysms recurred. The other 4 cases did not undergo angiography were followed as outpatients. All patients recovered normally. No death or permanant disablement occurred. Conclusion Endovascular covered stent placement is expedient and effective for treatment of internal carotid cavernous large and wide neck aneurysms and intradural vertebral dissecting or fusiform aneurysms. DOI：10.3969/j.issn.1672-6731.2011.02.01