Preliminary experience with the enterprise stent for endovascular treatment of complex intracranial aneurysms: potential advantages and limiting characteristics

Abstract

Objective: Stent-assisted coiling is an accepted endovascular treatment (EVT) for complex intracranial aneurysms. The Enterprise self-expandable stent (Cordis, Miami Lakes, FL) is a new retractable stent that is delivered via a conventional coiling catheter to potentially circumvent the limitations of other stents. The aim of this study was to evaluate the use of this stent for EVT of complex aneurysms.

Methods: Between January and May 2007, 14 patients with 15 unruptured wide-necked or fusiform aneurysms were treated. EVT consisted of stent placement and subsequent endosaccular coiling. Clinical outcome was assessed with the modified Glasgow Outcome Scale.

Results: EVT was successfully performed and led to an excellent outcome in all patients. The stent was easily navigated and precisely positioned in all cases. However, the stent's visibility was poor once it was delivered. Moreover, procedural complications occurred in three patients, including stent migration (n = 1) and coil protrusion between the stent and the vessel wall (n = 2). In these latter two cases, a remodeling balloon was required to assist in delivery of the coils. No clinical incidence of complications was observed when the parent artery had a diameter of more than 4 mm. Angiographic results consisted of eight complete occlusions, four neck remnants, and three incomplete occlusions.

Conclusion: The Enterprise stent is very useful for EVT of complex intracranial aneurysms because it is easy to navigate and place precisely. However, the currently available stent has two relatively limiting characteristics: 1) it has poor visibility, and 2) it should only be used for aneurysms located on a parent artery with a maximal diameter of 4 mm.