2017 年 11 巻 2 号 p. 59-64
Objective: Since stenting for assisting cerebral aneurysm embolization was approved, the therapeutic results of coil embolization for cerebral aneurysm have improved. However, various complications due to stent placement, including thromboembolism, have also been reported.
Materials and Methods: In 32 patients who could be followed up after stent-assisted coil embolization of cerebral aneurysms, chronological changes in the aneurysmal occlusion and characteristic complications were evaluated.
Results: The aneurysmal occlusion immediately after the treatment was complete occlusion (CO) in 6 patients (18.8%), neck remnant (NR) in 10 patients (31.1%), and body filling (BF) in 16 patients (50.0%). The aneurysmal occlusion at the follow-up was CO in 17 patients (53.1%), and aneurysmal obliteration was advanced in 14 patients (43.8%) during the follow-up period. As there are complications due to stent placement, occlusion of the parent vessel was noted during the treatment in one patient, and stenosis or kinking of the parent vessel or branches was observed during the follow-up in four patients. Of these four patients, two patients showed in-stent stenosis, one patient showed kinking of the parent vessel associated with linearization of the vessel by stenting, and one patient showed stenosis of a vessel branching from the site of stenting. All were asymptomatic.
Conclusion: Serial improvements in the aneurysmal occlusion were observed after stent-assisted coil embolization. Stenosis due to stretching of the parent vessel as well as in-stent embolization or stenosis may occur as characteristic complications of stenting, and long-term follow-up is necessary.