Extended Follow-Up Analysis of Intracranial Bifurcation Aneurysms Managed with Braided Stent-Assisted Coil Embolization: A Single-Center Experience

Öz

Objective: This study retrospectively analyzed clinical and angiographic follow-up data of patients who underwent braided stent-assisted coil embolization for intracranial bifurcation aneurysms in a single-center series. Methods: Between July 2023 and September 2025, 90 patients with unruptured intracranial bifurcation aneurysms were treated with braided stent-assisted coil embolization. Wide-neck aneurysms were defined as those with a neck diameter >4 mm or a dome-to-neck ratio <2 (1). All patients received dual antiplatelet therapy and underwent follow-up digitalsubtraction angiography (DSA) at 6 and 12 months, and magnetic resonance angiography (MRA) at 24 months. Thedegree of occlusion was evaluated according to the Roy–Raymond Occlusion Classification (RROC) (2). Results: The mean age was 59.9 years (range 28–79), and 48% of patients were female. Aneurysm locations were anterior communicating artery (n=38), middle cerebral artery (n=31), and basilar tip (n=21). All procedures were completed successfully with no technical failures. Periprocedural complications occurred in 3.3% of cases, all transient and without permanent morbidity. Complete occlusion (RROC Grade 1) increased from 35.6% immediately post-procedure to 84.4% at 24 months. Seven patients required retreatment with flow-diverter stents beyond 24 months due to residual aneurysm filling (3,4). Conclusion: Braided stent-assisted coil embolization is a reliable endovascular approach for treating intracranial bifurcation aneurysms. It demonstrates high procedural success, low complication rates, and progressive aneurysm occlusion during follow-up. The shelf and mild flow-diverting effects of braided stents contribute to durable long-term results, particularly in wide-neck and complex aneurysms.

Anahtar Kelimeler

• Intracranial aneurysm
• braided stent
• coil embolization
• bifurcation aneurysm
• endovascular treatment

Örgülü Stent Destekli Koil Embolizasyonu ile Tedavi Edilen İntrakraniyal Bifurkasyon Anevrizmalarının Uzun Dönem Takip Analizi: Tek Merkez Deneyimi

Öz

Amaç: Bu çalışmada örgülü stent destekli koil embolizasyonu ile tedavi edilen intrakraniyal bifurkasyon anevrizmalarının uzun dönem klinik ve anjiyografik sonuçları retrospektif olarak değerlendirildi. Yöntemler: Temmuz 2023 – Eylül 2025 tarihleri arasında, rüptüre olmamış intrakraniyal bifurkasyon anevrizması bulunan 90 hasta örgülü stent destekli koil embolizasyon yöntemiyle tedavi edildi. Geniş boyunlu anevrizma, boyun çapı >4 mm veya kubbe-boyun oranı <2 olarak tanımlandı (1). Tüm hastalara çiftli antiplatelet tedavi uygulandı ve 6. ile 12.aylarda DSA, 24. ayda MRG anjiyografi ile takip yapıldı. Oklüzyon durumu Roy–Raymond sınıflamasına göredeğerlendirildi (2). Bulgular: Ortalama yaş 59,9 (28–79) olup hastaların %48’i kadındı. Anevrizma yerleşimleri: ACoA (n=38), MCA (n=31), baziler tepe (n=21). Tüm olgularda teknik başarı sağlandı. %3,3 oranında, tamamı geçici olmak üzere işlem sırasında komplikasyon izlendi. Tam oklüzyon oranı (RROC Grade 1) işlem sonrası %35,6 iken, 24. ayda %84,4’e yükseldi. Yedi hasta, 24. ay sonrası rezidü nedeniyle flow-diverter stent ile yeniden tedavi edildi (3,4). Sonuç: Örgülü stent destekli koil embolizasyonu, intrakraniyal bifurkasyon anevrizmalarının tedavisinde güvenli, etkili ve uzun vadede başarılı bir yöntemdir. Özellikle geniş boyunlu ve kompleks yapılı anevrizmalarda “shelf” etkisi ve akım yönlendirici özellikleriyle uzun dönem oklüzyon başarısını desteklemektedir.

Anahtar Kelimeler

• İntrakraniyal anevrizma
• örgülü stent
• koil embolizasyonu
• bifurkasyon anevrizması
• endovasküler tedavi.

Kaynakça

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