FIGURE 1. Illustration of the retractable, self-expandable Enterprise stent (Cordis, Miami Lakes, FL). From: PRELIMINARY EXPERIENCE WITH THE ENTERPRISE.

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Presentation transcript:

FIGURE 1. Illustration of the retractable, self-expandable Enterprise stent (Cordis, Miami Lakes, FL). From: PRELIMINARY EXPERIENCE WITH THE ENTERPRISE STENT FOR ENDOVASCULAR TREATMENT OF COMPLEX INTRACRANIAL ANEURYSMSPOTENTIAL ADVANTAGES AND LIMITING CHARACTERISTICS Neurosurgery. 2008;62(5):1063-1070. doi:10.1227/01.NEU.0000312713.55567.AF Neurosurgery | Copyright © 2008 by the Congress of Neurological Surgeons

FIGURE 2. Patient 9, a 49-year-old woman with a history of subarachnoid hemorrhage and coiled aneurysms and an incidental vertebral artery (VA) aneurysm. A, three-dimensional angiogram showing a left VA aneurysm with a wide and circumferential neck. B, conventional angiogram showing multiple unusual loops of the left VA at the cervical level. Selective endovascular treatment (EVT) with the stent-assisted technique was performed. C, under road-mapping, a Prowler Plus microcatheter (Cordis, Miami Lakes, FL) was placed past the aneurysm neck. D, a 4.5-mm/28-mm Enterprise stent was loaded and delivered across the aneurysm neck. Then, a coiling catheter was navigated through the stent struts, and coils were delivered within the sac. E, Final angiographic control showed a neck remnant. From: PRELIMINARY EXPERIENCE WITH THE ENTERPRISE STENT FOR ENDOVASCULAR TREATMENT OF COMPLEX INTRACRANIAL ANEURYSMSPOTENTIAL ADVANTAGES AND LIMITING CHARACTERISTICS Neurosurgery. 2008;62(5):1063-1070. doi:10.1227/01.NEU.0000312713.55567.AF Neurosurgery | Copyright © 2008 by the Congress of Neurological Surgeons

FIGURE 3. Patient 2, a 49-year-old man with an incidental aneurysm FIGURE 3. Patient 2, a 49-year-old man with an incidental aneurysm. Conventional (A) and three-dimensional angiograms (B and C) of the right VA showing a fusiform aneurysm. Selective EVT with the stent-assisted technique was performed. A 4.5-mm/28-mm Enterprise stent was positioned across the aneurysm, and several coils were delivered within the sac. D, final angiographic control showing a neck remnant. From: PRELIMINARY EXPERIENCE WITH THE ENTERPRISE STENT FOR ENDOVASCULAR TREATMENT OF COMPLEX INTRACRANIAL ANEURYSMSPOTENTIAL ADVANTAGES AND LIMITING CHARACTERISTICS Neurosurgery. 2008;62(5):1063-1070. doi:10.1227/01.NEU.0000312713.55567.AF Neurosurgery | Copyright © 2008 by the Congress of Neurological Surgeons

FIGURE 4. Patient 7, a 29-year-old man who presented with seizures related to a 70-mm temporal arteriovenous malformation (AVM). Multiple incidental aneurysms were found. Selective EVT was performed on an associated aneurysm located at the basilar artery-left superior cerebellar artery junction. A, conventional angiogram showing three aneurysms of the posterior circulation: one small-necked left posteroinferior cerebellar artery aneurysm that had previously been coiled and two wide-necked aneurysms located on the basilar trunk-left superior cerebellar artery junction and on the left posterior cerebral artery. A 4.5-mm/37-mm Enterprise stent was placed from the P2 segment of the left posterior cerebral artery to the midportion of the basilar trunk to cover both wide-necked aneurysms. B, a microcatheter was then advanced through the stent struts, and coils were delivered within the sac. However, coil protrusion occurred between the stent and the parent artery wall. Therefore, a remodeling balloon was placed within the stent to assist coil deposition. C and D, final angiographic controls showing complete aneurysm occlusion. From: PRELIMINARY EXPERIENCE WITH THE ENTERPRISE STENT FOR ENDOVASCULAR TREATMENT OF COMPLEX INTRACRANIAL ANEURYSMSPOTENTIAL ADVANTAGES AND LIMITING CHARACTERISTICS Neurosurgery. 2008;62(5):1063-1070. doi:10.1227/01.NEU.0000312713.55567.AF Neurosurgery | Copyright © 2008 by the Congress of Neurological Surgeons

(Left) Pair of extracranial angioplasty catheters for balloon inflation (small syringe) and injection of heparinized arterial blood (large syringe). (Right) Magnified view of a balloon tip. From, Rumbaugh CL, Wang A, Tsai FY: Cerebrovascular Disease, Imaging and Interventional Treatment Options. New York, IGAKU-SHOIN Medical Publishers, Inc., 1995. From: PRELIMINARY EXPERIENCE WITH THE ENTERPRISE STENT FOR ENDOVASCULAR TREATMENT OF COMPLEX INTRACRANIAL ANEURYSMSPOTENTIAL ADVANTAGES AND LIMITING CHARACTERISTICS Neurosurgery. 2008;62(5):1063-1070. doi:10.1227/01.NEU.0000312713.55567.AF Neurosurgery | Copyright © 2008 by the Congress of Neurological Surgeons