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(10/30/04 12:00 am)
Stenting treatment could stopper wide-neck aneurysms
Stenting treatment could stopper wide-neck aneurysms
Patients with wide-neck aneurysms may be able to avoid traditional surgical clipping with the advent of a novel stenting procedure, according to physicians at the University of Maryland Medical Center.

The current method for treating narrow-neck aneurysms -- packing them with tiny coils to redirect blood flow -- is not up to the task in wide-neck aneurysms. The coils simply fall out of the aneurysm. Wide-neck aneurysms occur in about 25% of people with brain aneurysms.

Physicians traditionally have to perform surgery to treat wide-neck aneurysms, but surgery isn't always an option, especially for hard-to-reach locations.

The Maryland physicians are trying a new procedure that involves bridging the wide opening of the aneurysm with a stent, which provides a framework that keeps inserted coils from falling out. Over time, blood clots on the coil seal up the aneurysm.

"One woman had already been to surgery, and the neck of her aneurysm was so wide that the surgeons weren't able to clip it. They had to back out and close," said Dr. Gregg H. Zoarski, director of diagnostic and interventional neuroradiology at the medical center. "Three months later, the patient came back and we obtained beautiful results from this straightforward procedure."

The procedure isn't an option for all patients with wide-neck aneurysms. Especially in older patients, tortuous, angular vessels can make placing both the stents and the coils extremely difficult, according to Zoarski.

The stents used in the procedure have been available to the hospital only since last November, and the procedure is still relatively new. Studies following up the patients for possible recanalization and other complications would provide information needed to properly treat patients who cannot have surgery, he said.

"It would be good to know whether the stents may cause any inflammatory reaction in the vessel," Zoarski said. "Right now, we are reserving the stent for patients who don't have any surgical alternative."

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