Single-Stage Endovascular Management of Concurrent Intracranial Aneurysms and Arterial Stenoses: Clinical Outcomes, Procedural Strategies, and Predictive Factors
Sarshayev M. Makhanbetkhan S. Maidan A. Pons R.B. Davletov D. Zhumabekov A. Berdikhojayev M.
July 2025Multidisciplinary Digital Publishing Institute (MDPI)
Brain Sciences
2025#15Issue 7
Background: The coexistence of extracranial arterial stenoses and intracranial aneurysms presents a unique clinical dilemma. While staged interventions are traditionally preferred to reduce procedural risks, recent advances have enabled single-stage endovascular treatment. This study evaluates the clinical outcomes, procedural strategies, and predictive factors associated with such combined interventions. Methods: This retrospective study included 47 patients treated with single-stage endovascular procedures for concurrent extracranial stenosis and intracranial aneurysm between 2016 and 2024. Clinical, angiographic, and procedural data were collected. Outcomes were assessed using the mmodified Rankin Scale (mRS), and statistical analyses were performed to identify associations between clinical variables and functional outcomes. Results: Of the 47 patients, 85.1% achieved favorable outcomes (mRS 0–2) at ≥6-month follow-up. The most commonly treated arteries were the internal carotid artery (70.2%) and the middle cerebral artery (34%). Stent-assisted coiling or flow diversion was performed in 93.6% of aneurysm cases, while 91.5% underwent carotid or vertebral stenting. Lesion laterality (left-sided aneurysms, p = 0.019) and stenosis length (p = 0.0469) were significantly associated with outcomes. Smoking was linked to multiple stenoses (p = 0.0191). Two patients experienced major complications: one aneurysmal rebleed after stenting, and one intraoperative rupture. Conclusions: Single-stage endovascular treatment for patients with concurrent extracranial stenosis and intracranial aneurysm is technically feasible and clinically effective in selected cases. Lesion configuration, anatomical considerations, and individualized planning are critical in optimizing outcomes.
carotid artery stenosis , endovascular treatment , intracranial aneurysm , modified Rankin Scale , neurointervention , single-stage intervention , smoking , stroke prevention , subarachnoid hemorrhage , vertebral artery stenosis
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National Hospital of the Medical Center of the Presidental Affairs Administration of the Republic of Kazakhstan, Almaty, 050060, Kazakhstan
National Centre for Neurosurgery, Astana, 010000, Kazakhstan
Al Qassimi Hospital, Dubai, 25314, United Arab Emirates
Atchabarov Scientific-Research Institute of Fundamental and Applied Medicine, Asfendiyarov Kazakh National Medical University, Almaty, 050000, Kazakhstan
National Hospital of the Medical Center of the Presidental Affairs Administration of the Republic of Kazakhstan
National Centre for Neurosurgery
Al Qassimi Hospital
Atchabarov Scientific-Research Institute of Fundamental and Applied Medicine
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