Progressive occlusion of aneurysms in Neuroform stent-assisted treatment of intracranial aneurysms

Introduction: The long term effect of Neuroform stent in progressive occlusion of intracranial aneurysms is not yet completely understood. Here the effect of the Neuroform stent in progressive occlusion of intracranial aneurysms and clinical outcome is reported. Methods: Consecutive patients treated with the Neuroform stent from January 2003 to July 2007 were prospectively enrolled. Patients' demographics, immediate and delayed rate of occlusion, and clinical outcomes using the National Institution of Health Stroke Scale (NIHSS) and the Glasgow Outcome Scale (GOS) were recorded. Results: Neuroform stent placement was attempted in 72 patients, including 10 ruptured cases. However, stent placement could not be accomplished in two patients who were not included for analysis. Mean age was 50±14 years and mean aneurysm diameter was 10.28±5.9 mm. Immediate complete occlusion was observed in 31 (44%), neck remnants in 29 (41%) and subtotal occlusion in 10 (14%). Angiographic follow-up was available in 59 cases; complete occlusion was observed in 48/59 (81%), neck remnant in 7/59 (13%) and recanalisation in 4/49 (7%). Of 39 patients with immediate incomplete obliteration, progressive complete occlusions were achieved in 25/31 (81%), no changes in two and recanalisation in four cases. The majority of patients had good outcomes (GOS 1 or NIHSS 0 in 66/70 (94%), GOS 2 or NIHSS 2 in one patient and GOS 3 or NIHSS 4 in three at the 90 day follow-up visit. Conclusions: The Neuroform stent assisted neck remodelling technique improves progressive obliteration of intracranial aneurysms with a low recanalisation rate and good clinical outcome.