Long-term Results of Enterprise Stent-assisted Coiling of Cerebral AneurysmsMaryam Rahman, MD1, Kyle M. Fargen, MD1, Maryam Rahman, MD1, Brian L. Hoh, MD1, Babu G. Welch, MD1, Giuseppe Lanzino, MD1, Alan S. Boulos, MD1, Jeffrey Carpenter, MD1, Ansaar T. Rai, MD1, Erol Veznedaroglu, MD1, Andrew J. Ringer, MD1, Rafael Rodriguez-Mercado, MD1, Peter Kantzemann, MD1, Adnan H. Siddiqui, MD, PhD1, Elad I. Levy, MD1, J D. Mocco, MD11Gainesville, FL United States Keywords: stent, outcome, endovascular stent, coiling, aneurysmInteractive ManuscriptAsk Questions of this Manuscript: What is the background behind your study?The Enterprise Vascular Reconstruction Device and Delivery System (Cordis; the Enterprise stent) was approved for use in conjunction with coiling of wide-necked aneurysms in 2007. What is the purpose of your study?No published long-term aneurysm occlusion or complication data exists for the Enterprise system. Describe your patient group.Two-hundred and twenty-nine patients with 229 aneurysms, 32 of which were ruptured aneurysms, were included in the study. Describe what you did.An eight-center registry was created to evaluate large volume data on the delayed safety and efficacy of the Enterprise stent system. Pooled data were compiled for consecutive patients undergoing Enterprise stent-assisted coiling at each institution prior to May 2009. Describe your main findings.Mean clinical and angiographic follow-up was 619.6 ± 26.4 days and 655.7 ± 25.2 days, respectively. Mean aneurysm size was 9.2 ± 0.4 mm. Fifty-nine percent of patients demonstrated 100% coil obliteration and 81% had 90% or higher occlusion at last follow-up angiography. A total of 19 patients (8.3%) underwent re-treatment of their aneurysms during the follow-up period. Angiographic in-stent stenosis was seen in 3.4% and thromboembolic events occurred in 4.4%. Overall, 91% of patients who underwent Enterprise-assisted coiling had a modified Rankin Score (mRS) of 2 or less at last follow-up. Poor mRS was strongly associated with rupture status (p < 0.001). Describe the main limitation of this study.This is a retrospective study. Describe your main conclusion.The Enterprise stent system is an effective, safe, and durable treatment for intracranial aneurysms when used in conjunction with coiling. Describe the importance of your findings and how they can be used by others.This question was not answered by the author The Enterprise Vascular Reconstruction Device and Delivery System (Cordis; the Enterprise stent) was approved for use in conjunction with coiling of wide-necked aneurysms in 2007. No published long-term aneurysm occlusion or complication data exists for the Enterprise system. Two-hundred and twenty-nine patients with 229 aneurysms, 32 of which were ruptured aneurysms, were included in the study. An eight-center registry was created to evaluate large volume data on the delayed safety and efficacy of the Enterprise stent system. Pooled data were compiled for consecutive patients undergoing Enterprise stent-assisted coiling at each institution prior to May 2009. Mean clinical and angiographic follow-up was 619.6 ± 26.4 days and 655.7 ± 25.2 days, respectively. Mean aneurysm size was 9.2 ± 0.4 mm. Fifty-nine percent of patients demonstrated 100% coil obliteration and 81% had 90% or higher occlusion at last follow-up angiography. A total of 19 patients (8.3%) underwent re-treatment of their aneurysms during the follow-up period. Angiographic in-stent stenosis was seen in 3.4% and thromboembolic events occurred in 4.4%. Overall, 91% of patients who underwent Enterprise-assisted coiling had a modified Rankin Score (mRS) of 2 or less at last follow-up. Poor mRS was strongly associated with rupture status (p < 0.001). This is a retrospective study. The Enterprise stent system is an effective, safe, and durable treatment for intracranial aneurysms when used in conjunction with coiling. Project Roles:
M. Rahman (), K. Fargen (), M. Rahman (), B. Hoh (), B. Welch (), G. Lanzino (), A. Boulos (), J. Carpenter (), A. Rai (), E. Veznedaroglu (), A. Ringer (), R. Rodriguez-Mercado (), P. Kantzemann (), A. Siddiqui (), E. Levy (), J. Mocco ()
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