Background

The usage of endovascular stents has allowed denser aneurysm packing along with increased aneurysm neck coverage allowing for the treatment of more complex aneurysms. Local protocol dictates that elective aneurysm cases are managed post-operatively in the High Dependency Unit (HDU).

Objective

To determine the safety of intracranial stenting in the treatment of intracranial aneurysms by analysing the post-operative complication rates and immediate outcomes.

Methods

A total of 49 patients were treated in our institution over 18 months. Stents used include: LVIS EVO, Atlas, FRED X, Baby Leo, Pipeline Shield, Silk Vista, Acclino, Neuroform, Pipeline vantage, and Trevo stents.

Results

A total of 49 patients were included. 3 required HDU input, of which 1 had a thromboembolic complication from treatment, 1 had an intra-operative aneurysmal rupture requiring an EVD, 1 patient had contrast induced neurotoxicity which improved spontaneously. There were no mortalities. 4 patients had minor groin puncture site haematoma which did not require intervention and could have been managed in normal ward. 42 had non-complicated endovascular treatment, 35 of which went home next day from HDU and 7 others were discharged to ward next day before going home. Overall mean stay in HDU was 1.22 days.

Conclusions

Thromboembolic and haemorrhagic complication rate from stent assisted coiling or flow diversion at our centre is low. All the non-complicated cases did not require HDU input and could have been moved to normal ward post operatively, to ease bed pressure and save cost.