Abstract 2750: Comparison of Enterprise with Neuroform Stent-Assisted Coiling of Intracranial Aneurysms
INTRODUCTION: The Enterprise (Codman, Raynham, MA) is the first closed-cell stent designed to treat wide-necked intracranial aneurysms. Advantages of the design can include improvement in keeping coils within the aneurysm and the ability of the stent to be partially deployed and recaptured. We compared the technical and clinical complications of the Enterprise with the Neuroform (Stryker, Kalamazoo, MI).
METHODS: Between March 2007 and June 2011, Enterprise stent-assisted coil embolization was attempted for 106 aneurysms in 96 patients (mean age 58, 81 female) who were enrolled in a prospective registry. Deployment success and difficulty, stent movement and misplacement, and 30 day symptomatic neurological events were compared with a prospective cohort of patients treated with all generations of the Neuroform using a two-tailed Fisher exact test with p < 0.05 accepted for significance.
RESULTS: Enterprise stent deployment success was high (107 of 113 attempts, 94.7%) with 101 of the 106 aneurysms receiving a stent. The delivery microcatheter could not be positioned in 5 cases. Two stents were deployed with difficulty (1 guide catheter change and 1 recapture prior to deployment). Six cases required a second stent for misplaced stents (n = 4), stent movement on coiling attempt (n = 1) and down-sizing because a longer stent could not be unsheathed (n = 1). There were 12 periprocedural thromboembolic or hemorrhagic events consisting of 7 transient ischemic attacks (TIA), 3 ischemic strokes and 2 intracranial hemorrhages. One TIA was attributed to non-compliance with antiplatelet therapy. One hemorrhage presented 2 days later, thought to be related to antiplatelet therapy. Results are compared with the Neuroform in the table below.
CONCLUSION: The Enterprise is significantly easier to deploy than the Neuroform; however, there are more thromboembolic complications in the form of periprocedural TIA and stroke. Hemorrhagic complication rates were similar.
- © 2012 by American Heart Association, Inc.