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Stenting as Monotherapy for Uncoilable Intracranial Aneurysms

BACKGROUND: Small, blister-like aneurysms (BLAs), by virtue of their unique morphology, are difficult to treat with conventional modalities. The use of oversized self-expanding stents as monotherapy for BLAs is a relatively new and promising concept that warrants further investigation. OBJECTIVE: To clarify the role of oversized self-expanding stents as monotherapy for BLAs. METHODS: Five consecutive patients were treated for BLAs with oversized self-expanding stents alone by the senior author (K.R.B.). We report on their clinical and radiographic outcomes. RESULTS: All 5 patients in our series were discharged in good clinical condition. Complete aneurysm occlusion was observed in all patients at the time of most recent radiographic follow-up. Mean follow-up time was 13.6 months (range, 1 month to 4.5 years). CONCLUSION: The use of oversized self-expanding stents to redirect flow away from aneurysms is an effective option for patients with BLAs. This approach represents an alternative to the use of flow diverters. ABBREVIATIONS: BLA, blister-like aneurysm CTA, computed tomography angiogram ICA, internal carotid artery SAH, subarachnoid hemorrhage