Horizontal stent-assisted coil embolisation of wide-necked intracranial aneurysms with the Enterprise stent-a case series with early angiographic follow-up

The purpose of the study is to describe our experience in eight cases of horizontal stenting across the circle of Willis in patients with terminal aneurysms. Eight patients were treated with horizontal stent placement and aneurysm coiling. All aneurysms had highly unfavourable dome to neck ratios. All patients were followed up with digital subtraction angiography at 3-12 months following treatment. The Enterprise stent was successfully deployed horizontally in vessels of less than 2-mm diameter with no stent occlusion. Neurological complications occurred in one patient. Immediate and follow-up angiographic results were encouraging with six stable occlusions at 6 months. There was one asymptomatic case of in-stent stenosis and one case of late organised in-stent thrombus. Horizontal deployment of the Enterprise stent to assist coil embolisation of wide-necked terminal aneurysms is feasible. This device can be navigated via relatively small communicating arteries, in cases with favourable anatomy. Early angiographic results were favourable; however, longer-term follow-up will be required.