Combined stent and coil in endovascular treatment of intracranial wide-necked and fusiform aneurysms.

Wide-necked and fusiform aneurysms are challenges for interventional neuroradiologists and neurosurgeons since they may involve entire vessels or be irregular in shape, making is possible for Guglielmi detachable coil to protrude into the parent arteries. This study was to evaluate the endovascular treatment of intracranial wide-necked and fusiform aneurysms by using a combination of stents and coils.From October 2000 to July 2001, eighteen patients with intracranial wide-necked or fusiform aneurysms were treated with intraluminal stenting in combination with endosaccular coiling.Stent placement and coil packing were technically successful in all patients. There were no complications related to the procedure except for the migration of the stent in four cases. The aneurysms were embolized with the coils after precise stenting, and total occlusion was obtained in 13 cases, neck remnants in 3, and loose occlusion in 2. All the patients recovered well. Short-term follow-up angiograms suggested patency of the parent arteries without recanalization.A combination of endovascular stenting and coil packing may be a favorable alternative for the treatment of intracranial aneurysms that are unsuitable for surgical clipping or coil embolization. Further study is necessary to assess the long-term outcome.