Procedural implantation of stents for brain aneurysms treatment
Brain stents, such as flow diverters and Y-stent-assisted coiling, are proving to be effective in treating intracranial aneurysms, particularly complex, wide-necked, or recurrent ones. A study showed that a specific type of stent fully diverted blood flow away from the aneurysm in 36% of people by 36 months after the surgery.
The Silk Vista flow diverter stent, for instance, demonstrated an 83% complete aneurysm occlusion at the one-year follow-up in patients with recurrent cerebral bifurcation aneurysms. The Y-stent-assisted coiling (Y-SAC) using pEGASUS stents also achieved high rates of immediate and sustained aneurysm occlusion with minimal complications in wide-necked intracranial bifurcation aneurysms.
Traditional surgical clipping of aneurysms provides a durable cure with recurrence rates under 2% over 10 years, while endovascular coiling, a less invasive method, has a higher recurrence rate requiring retreatment in 10–15% of cases. Newer devices like the Surpass Elite flow diverter enable treatment of a wider variety of aneurysms via minimally invasive approaches with improved safety profiles.
Placing a stent creates a potential risk for a blood clot, but doctors monitor the stent in the weeks and months after placement to check blood flow. A person may need to take a blood thinner after stent placement to reduce the risk of a blood clot. The hospital stay after a stent procedure is typically only a day or two, and the incision site in the groin can be sore and bruised, but people are often back to normal activities within a week or two.
The U.S. Food and Drug Administration approved the first stent to treat brain aneurysms, and stent placement is a procedure to treat a brain aneurysm. Aneurysms are weak spots on blood vessels in the brain where blood starts to pool. If an aneurysm bursts, it can bleed into the brain, which can be life-threatening. A stent is a short, flexible mesh tube that redirects blood away from the aneurysm, significantly reducing the risk of it bursting.
Other treatments for a brain aneurysm include microvascular clipping and coil embolization. The treatment for a brain aneurysm depends on its location and size, as well as the person's individual health history. Some aneurysms do not need treatment right away and are monitored over time.
A study of people up to three years after brain stent placement showed that a majority of blood vessels with a stent did not have significant narrowing, indicating that the stents maintain their effectiveness over time. Longer follow-up and larger studies are needed to fully establish outcomes beyond one year, but current evidence supports that brain stents offer durable aneurysm exclusion with good long-term safety. Dual antiplatelet therapy protocols are critical to reducing thromboembolic complications and are typically continued for months after stent placement.
