RESUMO
Background: This study aimed to evaluate the angiographic and clinical outcome, with an emphasis on long-term follow-up, of the LEO Plus stent for wide-neck intracranial aneurysms treated in a single center. Methods: We retrospectively examined a prospectively maintained database of patients treated with LEO Plus devices between January 2004 and December 2016. Data regarding patient demographics, aneurysm characteristics, and technical procedures were analyzed. Angiographic and clinical findings were recorded during the procedure and followed up over a period of at least 5 years. Results: We identified 101 patients with 116 aneurysms. In 16 patients, the stent could not safely be placed. Thus, a total of 97 LEO Plus devices were implanted in 97 aneurysms of 85 patients. Adverse events (acute and delayed) were observed in 21.6% of cases (17/85), and most were resolved (70.6%; 12/17). Moreover, 5 years after the procedure, total morbidity and mortality were 2.3% (2/85) and 3.5% (3/85), respectively. Long-term imaging follow-up showed complete occlusions, neck remnants, and residual aneurysms in 73.1% (57/78), 14.1% (11/78), and 12.8% (10/78) of cases, respectively. Conclusions: Long-term results of treatment of brain aneurysms with LEO stent show high rates of adequate and stable occlusion over time, with acceptable morbidity and mortality.
RESUMO
Introducción. La trombosis aguda intrastent es una complicación potencialmente grave en el stenting intracraneal. Es primordial determinar cuál es la terapia más adecuada en las trombosis intrastent. Caso clínico. Mujer de 58 años, el primer caso de trombosis aguda de un stent intracraneal, que fue tratada con éxito mediante fibrinólisis tras la implantación de un dispositivo diversificador de flujo (Silk) en un aneurisma basilar fusiforme. Conclusión. La administración de abciximab como tratamiento de rescate parece segura en los casos de formaciones de trombos agudos intrastent (AU)
Introduction. Acute intrastent thrombosis is a potentially serious complication in intracranial stenting. It is essential to determine which therapy is the most suitable in intrastent thromboses. Case report. Female aged 58, the first case of acute thrombosis of an intracranial stent to be treated successfully by fibrinolysis after the implantation of a flow diverter device (Silk) in a fusiform basilar aneurysm. Conclusion. The administration of abciximab as a rescue treatment seems safe in cases involving the formation of acute intrastent thrombosis (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Stents , Oclusão de Enxerto Vascular/complicações , Trombose/terapia , Terapia Trombolítica/métodos , Tratamento de Emergência/métodosRESUMO
INTRODUCTION: Acute intrastent thrombosis is a potentially serious complication in intracranial stenting. It is essential to determine which therapy is the most suitable in intrastent thromboses. CASE REPORT: Female aged 58, the first case of acute thrombosis of an intracranial stent to be treated successfully by fibrinolysis after the implantation of a flow diverter device (Silk) in a fusiform basilar aneurysm. CONCLUSION: The administration of abciximab as a rescue treatment seems safe in cases involving the formation of acute intrastent thromboses.
TITLE: Tratamiento de rescate en la trombosis aguda del stent intracraneal.Introduccion. La trombosis aguda intrastent es una complicacion potencialmente grave en el stenting intracraneal. Es primordial determinar cual es la terapia mas adecuada en las trombosis intrastent. Caso clinico. Mujer de 58 años, el primer caso de trombosis aguda de un stent intracraneal, que fue tratada con exito mediante fibrinolisis tras la implantacion de un dispositivo diversificador de flujo (Silk) en un aneurisma basilar fusiforme. Conclusion. La administracion de abciximab como tratamiento de rescate parece segura en los casos de formaciones de trombos agudos intrastent.
