Tiny Cerebral Aneurysms Can Be Treated Safely and Effectively with Low-Profile Visualized Intraluminal Support Stent-Assisted Coiling or Coiling Alone.

BACKGROUND: The effectiveness and safety of LVIS stent-coiling is currently not known for treating tiny intracranial aneurysms.

OBJECTIVE: To investigate the effectiveness and safety of Low-profile visualized intraluminal support (LVIS) stent-assisted coiling and coiling alone in treating patients with mostly ruptured tiny aneurysms.

METHODS: Seventy-five patients with tiny intracranial aneurysms, including 63 ruptured ones, were treated endovascularly and analyzed.

RESULTS: In the coiling group, complete occlusion was achieved in 35 patients (83.6%)-nearly complete in 4 patients (9.5%) and noncomplete in 3 patients (7.1%). Intraprocedural rerupture occurred in 2 patients (4.8%), and coil protrusion occurred in 1 patient, with a complication rate of 7.1%. Clinical follow-up at 6-12 months revealed a modified Rankin Scale (mRS) score of 0-1 in 41 patients and 3 in 1 patient. In the stent-assisted group, occlusion was complete in 12 patients (36.4%), nearly complete in 15 patients (45.5%), and noncomplete in 6 patients (18.1%). Six stents (18.2%) did not have good adherence to the wall, with thrombus formation in 3 stents (9.1%). Follow-up angiography in 27 patients at 3-6 months showed no dislocation of the stents, complete occlusion in 24 patients (88.9%), and nearly complete occlusion in the other 3 patients. At 6 months, the mRS score was 0 in 30 patients and 2 in 3 patients. No significant (P > 0.05) differences existed between the 2 groups.

CONCLUSION: Tiny cerebral aneurysms can be safely and effectively treated with appropriate endovascular approaches based on aneurysm specific morphology, especially neck size and neck-to-dome ratio.