The Efficacy Of Enterprise Stent-Assisted Coil Embolization In The Treatment Of Intracranial Wide Necked Aneurysms By Magnetic Resonance Angiography

Use of stent-assisted coil seems to facilitate endovascular treatment of wide-necked intracranial aneurysms, while difficulty of deployment and stent thrombogenicity are the main drawbacks of the system. Thus, the objective of this present study was to assess the role of Enterprise stent-assisted coil embolization using magnetic resonance angiography (MRA) on patients with intracranial wide necked aneurysms. Patients were confirmed by digital angiography and MRA with intracranial wide necked aneurysms (n = 108) after which they were assigned into the Enterprise and non-Enterprise groups. Preoperative digital angiography and MRA examinations were recorded for observing the therapeutic effects, complications and prognosis of the two groups. MRA re-examination was performed post operation, and the sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of MRA on efficacy of intracranial wide necked aneurysms (efficacy of coil residual blood, aneurysm neck residual blood, parent artery patency, and adjacent artery patency) were calculated using ROC curve in accordance with the digital angiography results. In comparison with the non-Enterprise group, incidence of clinical symptoms including headache, drowsiness, oculomotor nerve palsy, stiff-neck and mental confusion significantly decreased, while the operation time and length of stay were shorter, and the incidences of ruptured aneurysm, shifting, prolapsing and unwinding of spring coil during operation declined in patients of the Enterprise group (all P < 0.05). According to the results of MRA re-examination, the postoperative Se, Sp, PPV and NPV of coil residual blood in patients of the Enterprise group were 85.7%, 97.9%, 85.7% and 97.9%, respectively, while the values of aneurysm neck residual blood were 88.9%, 95.6%, 80.0% and 97.7%, separately. The Se and PPV of parent artery patency were 92.6% and 100.0%, respectively, whereas those of adjacent artery patency were 90.0% and 100.0%, respectively. Considering digital angiography as the gold standard, ROC curve results of MRA diagnosing of patients with intracranial wide necked aneurysms were as follows: the area under the ROC curve (AUC) was 0.705, the sensitivity was 84.2%, and the specificity was 56.8%. Our results indicated that the efficacy of Enterprise stent-assisted coil embolization was superior than non-Enterprise stent-assisted coil embolization in treating intracranial wide necked aneurysms, while MRA was of high sensitivity and specificity in predicting the efficacy of Enterprise stent-assisted embolization in the treatment of intracranial wide necked aneurysms and could be used as an important tool and could aid in predicting the efficacy of endovascular interventional therapy for patients with wide necked intracranial aneurysms.