Long-term Results of Enterprise Stent-assisted Coiling of Cerebral Aneurysms

Maryam 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, MD1

1Gainesville, FL United States

Keywords: stent, outcome, endovascular stent, coiling, aneurysm

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Abstract

     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.
     


Acknowledgements

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 ()