Thromboembolic Events Associated with Neuroform Stent™ in Endovascular Treatment of Intracranial Aneurysms

BACKGROUND: The incidence of thromboembolic events associated with Neuroform stent (Boston Scientific Target, Fremont, CA) is known from previous studies but there are uncertainties of scale. PURPOSE: To report our rate of ischemic events associated with Neuroform stent. METHODS: Consecutive patients treated with Neuroform stent for intracranial aneurysms were prospectively enrolled from January 2003 to August 2006. Thromboembolic events as well as clinical outcomes were measured. Mean follow-up was 12 months. RESULTS: Successful stent deployment was achieved in (65/67) 97% of patients without any ischemic event. However, postoperative thromboembolic events were observed in 3 patients despite being on clopidogrel and aspirin. These 3 patients demonstrated poor platelet inhibitions in platelet aggregation (aggregometry) studies, and were successfully treated with intravenous eptifibatide with good outcome. The majority of the patients had good outcomes [Glasgow Outcome Score (GOS) 5 or National Institute of Health Stroke Scale (NIHSS) 0 in (63/67) 94%, GOS 4 or NIHSS 2 in 1 patient, and GOS 3 or NIHSS 4 was observed in 3 cases]. CONCLUSION: Our study reveals that the thromboembolic events associated with Neuroform stent may present in a delayed fashion. These events can be successfully treated with good outcome. Therefore, postoperative close follow-up is strongly recommended for all Neuroform stent-treated patients.