Safety of Endovascular Treatment for Concomitant Unruptured Intracranial Aneurysms and Cerebral Vascular Stenosis

Abstract Background To evaluate the safety of endovascular therapy for concomitant unruptured intracranial aneurysms (UIAs) and cerebral vascular stenosis. Methods Patients between January to August 2019 were retrospectively reviewed at our institution. Concomitant UIA and cerebral vascular stenosis patients underwent endovascular treatment were included. The demographics and clinical information were collected. Patients were divided into 4 groups according to lesions that was treated (aneurysm, stenosis, both lesions in a single session or in separated sessions). Patients were divided into another 2 groups based on locations of aneurysm and stenosis (ipsilateral and non-ipsilateral). The demographics and clinical data were compared among groups. Results A total of 105 (4.9%) cases have concomitant UIA and cerebral vascular stenosis. Eighty-one patients underwent endovascular treatment for the stenosis(n=18), aneurysm(n=41) or both lesions (one session=10; separated sessions n=12). Seven (8.6%) patients experienced procedural related complications, including 1 (1.2%) hemorrhagic and 6 (7.4%) ischemic types. In terms of procedures, 4 (6.3%) complications is related with UIA embolization, 2(5.0%) related with intracranial stenosis angioplasty. Complication rate of patients underwent intracranial angioplasty and aneurysm embolization simultaneously is much higher (20%) than that of the other groups (5.6%-8.3%). Patients with ipsilateral lesions also had higher complication rate (11.1%) than non-ipsilateral patients (6.7%). Follow-up (74 patients, mean=6.5months) result showed good clinical outcome in 70 (94.6%) patients. Conclusions Simultaneous treatment for concomitant UIA and extracranial stenosis may not pose additional risks. Ipsilateral lesions and single session procedure for intracranial stenosis and UIA are potential risk factors for periprocedural complications.