Willis covered
stents are used in clinical practice for some complex
cerebrovascular diseases. However, the performance of the Willis covered
stent requires further investigation. In this study, we investigate the safety and efficacy of Willis covered
stents for the treatment of complex
vascular diseases of the internal carotid artery (ICA).
METHODS: Thirteen patients with complex ICA diseases treated with the Willis covered
stent system at our institution from October 2016 to January 2018 were analyzed retrospectively. Follow-up observation and digital subtraction angiography (DSA) examination were conducted at about 6-10 months after the treatment.
RESULTS: The complex
vascular diseases of the ICA were successfully treated in 12 patients. The technical success rate was 92.3%. Pathologically, 13 lesions included blood
blister-like
aneurysm (n = 7), traumatic
pseudoaneurysm (n = 1), traumatic carotid artery
rupture (n = 1), and
aneurysm with
arteriovenous fistula (n = 4). Thirteen patients with complex
vascular diseases of the ICA were treated with 15 Willis covered
stents. The release sites of Willis covered
stents were the C7 (n = 2), C6 (n = 1), C5 and/or C4 (n = 9), and the C2 (n = 3) segment of the ICA. DSA performed immediately after
stent deployment revealed that complete occlusion of the lesion was achieved in 11 patients and
endoleak was observed in 2 patients. Of the 11 patients, postoperative DSA examination indicated that the lesions were occluded completely. Among 2 patients, who had a second
stent implantation at the break of the ICA, the traumatic ICA
rupture was essentially completely obstructed in 1 patient. The
endoleak remained in 1 patient with
carotid cavernous sinus fistula because the placement of the second
stent system was difficult with his ICA tortuosity. No recurrence of
aneurysms, hemorrhagia, and other lesions was observed, and the patients' parent arteries were patent without
stenosis. No procedure-related complications or deaths occurred during follow-up.
CONCLUSIONS: For the treatment of complex
vascular diseases in the ICA, Willis covered
stent implantation is safe and effective. However, longer follow-up, large-sample controlled studies, and multicenter studies are needed for further confirmation.