Neuroform stent-assisted treatment of intracranial aneurysms: long-term follow-up study of aneurysm recurrence and in-stent stenosis rates.

Introduction: Our purpose was to analyze the long-term evolution of wide neck cerebral aneurysms treated with stent assistance.

Methods: Data of consecutive patients treated with the Neuroform stent over 9 years were retrospectively analyzed with emphasis on periprocedural complications, aneurysm occlusion grade evolution, and in-stent stenosis rates.

Results: Altogether, 113 patients with 117 unruptured and ruptured aneurysms were subject of analysis. Mean aneurysm size was 9.4 mm, and mean neck size was 4.7 mm. Procedural thromboembolic and hemorrhagic complications affected eight (6.8%) and four cases (3.4%), respectively. Immediate complete occlusion and occlusion with residual neck was achieved in 85% of cases, which at the first follow-up of 6 months, changed to 77 and 76 % at 36 months. Aneurysms ≥10 mm showed a higher tendency of recurrence. During the overall follow-up time ranging from 1 to 9 years, an in-stent stenosis of ≥50 % was observed only in three cases, all of them being asymptomatic.

Conclusions: Stent-assisted coiling of wide neck aneurysms provided stable occlusion over the long-term follow-up, with very low and silent in-stent stenosis rates. Some incompletely occluded aneurysms showed a tendency of progressive occlusion; however, this was counterbalanced by the regrowth of others.