An Innovative Treatment Option for Ruptured Brain Aneurysms

A new study has found that stent-assisted embolization could help treat ruptured wide-necked intracranial aneurysms during acute subarachnoid hemorrhage (SAH).

Researchers from Tampere University Hospital (Finland) studied the effects of stent-assisted embolization in 61 patients (including 41 women and 20 men) who were treated for SAH at three Finnish hospitals over a four-and-a-half-year period. In the study, interventional radiologists performed coil embolization by first placing a wire stent over the neck of the aneurysm to help keep the coils within the aneurysmal sac, and then threaded a balloon-tipped catheter to the site of the aneurysm to perform the actual coil embolization. The procedure was a technical success in 44 (72%) of the 61 patients, and adequate blood flow was restored in 64% of the patients. The technique-related complication rate was 21%, and the 30-day mortality rate was 20%. There was only one case of rebleeding, and clinical outcome was good for the majority of the patients. The study was published on August 25, 2009, in the online edition of the journal Radiology.

"Stent-assisted coil embolization is a feasible method for the endovascular treatment of wide-necked intracranial aneurysms that are difficult to treat surgically or with balloon-assisted embolization during acute SAH,” concluded lead author Olli Tähtinen, M.D., and colleagues of the departments of diagnostic radiology and neurosurgery. "The risk of subsequent rerupture of the aneurysm seems to be reduced for aneurysms treated early, compared with that for nonsecured aneurysms.”

Stent-assisted embolization could help treat ruptured brain aneurysm when the neck of the aneurysm is wide, since the metal coils used for embolization have a tendency to protrude out of the aneurysmal sac and into the artery itself.

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Tampere University Hospital