Intimal thickening after placement of a neuroform stent: Its incidence and relation to angiographic follow-up results of aneurysm embolization

Little attention has been given to the intimal thickening of the parent artery associated with the use of Neuroform stent. The purposes of this study were are to analyze quantifyanalyze the incidence of the parent artery intimal thickening the incidence and pattern of luminal changes, to to see somedetermine possible predictors of the phenomenonof the intimal thickening, to to evaluate the its effecthe phenomenonrestenosis on the aneurysm treatment results. We reviewed the initial and six-month follow-up angiographic images in 32 intracranial aneurysm patients treated with Neuroform stent and coilsin wide-necked aneurysm treatment. The initial embolization results were evaluated by the Raymond and Roy classification. The angiographic changes from immediate post-embolization to the six-month follow-up were classified as 'improved'. 'unchanged' and 'worse'. The occurrencerates of parent artery intimal thickening was observed. Any perceivable change in the stented segment of the parent artery was considered as 'intimal thickening' and any change of ≥50 % as 'significant thickening'. Fisher exact tests and logistic regression analysis were applied to determine the relation between the occurrence of the intimal thickening and several variables. The incidence of the intimal thickening was 18.8% (6/32) and of significant thickening, 3.1% (1/32). The change in angiographic occlusion of the aneurysm was 'improved' in 40.6 % (13/32), 'unchanged' in 37.5% (12/32), and 'worse' in 21.9% (7/32). Among the variables, patient's age (≥55) and follow-up angiographic results ('improved') correlated with the occurrence of the intimal thickening. Of notable finding was all six cases with intimal thickening of the parent artery were associated with 'improved' in their follow-up angiographic result. Neuroform-associated intimal thickening usually occurs in younger patients and is frequently associated with improved angiographic result of the aneurysm embolization on follow-up.