To explore the safety and efficacy of small-sized stents in the treatment of unruptured distal anterior cerebral aneurysms.

A retrospective analysis was conducted on 29 patients with 29 aneurysms who were admitted to our center and treated with low-profile stents from January 2018 to December 2023. Among them, 15 aneurysms were located in the A2 segment and 14 aneurysms were located in the A3 segment. After the procedure, the Raymond-Roy grading standard was used to judge the degree of occlusion of the aneurysm, and the modified Rankin scale (mRS) was used to evaluate the clinical prognosis.

A total of 29 stents were placed in 29 patients (29 aneurysms), and the success rate of stent placement was 100%. The immediate postoperative aneurysm occlusion results indicated class Ⅰ in 17 cases (58.6%), class Ⅱ in 11 cases (37.9%), and class Ⅲ in 1 case (3.5%) based on R-R classification. Among 29 patients, 3 patients (10.3%) had complications during the perioperative period, all of which were ischemic complications. After thrombolysis or tirofiban treatment, the thrombus dissolved, of which only one patient had postoperative right-sided muscle strength grade 3, review of cranial MR suggested a small frontal lobe cerebral infarction, and the patient's symptoms improved before discharge, and right-sided muscle strength was grade 4 at 6-month postoperative follow-up. There were no hemorrhagic complications in any of the patients. A total of 22 patients underwent digital subtraction angiography (DSA) examination, which indicated class Ⅰ in 20 cases (90.9%), class Ⅱ in 1 case (4.5%), class Ⅲ in 1 case (4.5%), and 1 patient had aneurysm recurrence. At 6 months postoperatively, 29 patients had mRS score ≤ 2.

For treatment of unruptured distal anterior cerebral aneurysms, small-sized stents-assisted embolization is safe and effective. Braided stents tend to have better long-term embolization but can lead to intraoperative thrombosis.