Stent Application for the Treatment of Cerebral Aneurysms

Endovascular treatment becomes a main stream for the treatment of both ruptured and unruptured cerebral aneurysms. Rapid and striking advances in both the techniques and devices make it possible to treat most of cerebral aneurysms endovascularly. Since Higashida et al. first reported the use of a balloon-expandable coronary stent as a scaffold for coiling of basilar artery aneurysm in 1997 [1], several pathfinders have applied balloon-expandable stents to uncoilable lesions such as dissecting, fusiform or wide-necked aneurysms [2-5]. However, several limitations and inherent risks of the balloon-mounted stents prohibited general acceptance of the stent-assisted coiling technique. Since the 1st self-expanding stent (Neuroform) had been introduced and approved to assist the coil embolization in 2001, stent has become one of the most important tools in treating difficult aneurysms not feasible for simple coiling At present, 5 types of stents dedicated for intracranial use are available in the worldwide market: 4 stents (Neuroform, Solitaire, Enterprise, and Leo plus) for assisting coiling and 1 stent (Wingspan) for the treatment of intracranial atherosclerotic disease. Except for the Leo plus, 4 types of stents are currently available in our country. The physical features, the dimensions, and the functional characteristics of these stents show considerable differences There are also many strategies and tips to treat difficult aneurysms by using stent(s), with or without coiling It is assumed that, in individual cases, interventional neuroradiologists or neurosurgeons follow their personal preferences, and which stent and how it is used may be decided according to their clinical experience. Nevertheless, they require much experience in clinical practice as well as knowledge of the stents to treat cerebral aneurysms safely and effectively. In this report, a brief review of properties of the currently available stents and strategies of their application is presented.