Beneficial Remodeling of Small Saccular Intracranial Aneurysms after Staged Stent Only Treatment: A Case Series

Background We evaluated the effect of stent alone treatment for small intracranial aneurysms that were not amenable to coil embolization without prior stent reconstruction. Methods This case series was conducted in the neurosurgical service at a tertiary care hospital in Denver, Colorado. Nine patients were electively treated for intracranial aneurysms. All patients had a single low porosity stent reconstruction device placed across the neck of a small intracranial aneurysm. The main outcome measures were changes in aneurysm size and parent vessel morphology during follow-up. Results Nine patients underwent stent alone treatment for unruptured intracranial aneurysms. The mean follow-up period was 9.6 months (range 6-17 months). There were no cases of periprocedural morbidity or aneurysm rupture during follow-up. All aneurysms decreased in size, and 3 of 9 aneurysms were gone at follow-up. In addition, at follow-up all parent vessels demonstrated straightening about the aneurysm site. Conclusions Beneficial remodeling with a decrease in the size of small intracranial aneurysms may be seen after treatment with a single stent alone, particularly if the aneurysm arises at an arterial bend or bifurcation. This phenomenon may be related to a degree of straightening of the parent artery, improving hemodynamic conditions about the aneurysm site.