Radiology: Stent-assisted embolization effective aneurysm treatment

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Finnish researchers have found that stent-assisted coil embolization could be an effective treatment of ruptured brain aneurysms.

Olli Tähtinen, MD, assistant professor of radiology at Tampere University Hospital in Tampere, Finland, and colleagues reported their conclusions in the Aug. 26 online edition of Radiology.

In the study, researchers examined the effects of stent-assisted embolization on 61 patients (41 female, 20 male) who were treated for subarachnoid hemorrhage at three Finnish hospitals over a 4.5-year period.

When an aneurysm ruptures, the ruptured vessel can be repaired surgically through embolization, in which the aneurysm is filled with metal coils in order to prevent repeat bleeding and restore normal blood flow in the artery. According to the researchers, embolization is challenging when the neck of the aneurysm is wide because metal coils can protrude out of the aneurysm and into the cerebral artery. Although a balloon-tipped catheter threaded to the site of the aneurysm is one treatment method, it doesn’t always solve the problem

In this study, a radiologist performed coil embolization by placing a stent over the neck of the aneurysm to keep the coils within the aneurismal sac. In six of the cases the stent could not be deployed because of the tortuosity of the arteries. The coiling was unsuccessful in three other cases because the aneurysm was too small, and in two cases because of the unfavorable anatomy of the aneurysm and the tortuosity of the target vessel. The total mortality rate was 21 percent. But, the procedure did achieve a technical success rate of 72 percent success (44 out of 61) while an adequate blood flow was restored in 39 of the patients.

“Our study shows that stent-assisted coil embolization is a feasible treatment option for ruptured brain aneurysms that are difficult to treat surgically or with balloon-assisted embolization,” Tähtinen said. "Stent-assisted embolization may offer an important addition to the treatment repertoire for these critically ill patients."