TY - JOUR
T1 - Results of stent-assisted vs non-stent-assisted endovascular therapies in 489 cerebral aneurysms
T2 - Single-center experience
AU - Jahshan, Shady
AU - Abla, Adib A.
AU - Natarajan, Sabareesh K.
AU - Drummond, Patrick S.
AU - Kan, Peter
AU - Karmon, Yuval
AU - Snyder, Kenneth V.
AU - Hopkins, L. Nelson
AU - Siddiqui, Adnan H.
AU - Levy, Elad I.
N1 - Publisher Copyright:
© 2012 by the Congress of Neurological Surgeons.
PY - 2013
Y1 - 2013
N2 - BACKGROUND: Whether the addition of stenting to intracranial aneurysm coil embolization results in benefit in terms of occlusion rates or additional risk in terms of periprocedural adverse events is not clear. OBJECTIVE: To report retrospectively analyzed results of endovascular aneurysm treatment comparing stent-assisted coiling with coiling without stents at our hospital from 2005 to 2009. METHODS: In this retrospectively reviewed case series, aneurysms were grouped as intent-to-treat or initially treated with stent-assisted coiling (A) vs coiling alone (B) or as-treated - those that ultimately received a stent (C) or not (D). Complication and occlusion rates were compared between groups. Some patients crossed fromgroup B to C after receiving stent placement at a later treatment following the initial therapeutic modality (without a stent). RESULTS: In 459 patients, 489 aneurysms were treated by group as follows: A = 181, B = 308, C = 225, and D = 264. In stent groups (A and C), there were significantly lower frequencies of ruptured aneurysms (A vs B = 11% vs 62%, P < .001; C vs D = 20.4% vs 62.5%, P < .001) and more giant aneurysms (A vs B = 7.3% vs 1.0%, P = .001; C vs D = 5.9% vs 1.1%, P < .001). There was no statistically significant difference in permanent event-related morbidity (A vs B = 4.4% vs 4.2%, P = 1.0; C vs D = 4.4% vs 4.2%, P = 1.0). Average angiographic follow-up after last treatment was 18.2 ± 15 months (median = 14). Higher rates of complete occlusion at last angiographic follow-up were observed in stented aneurysms (A vs B = 64.6% vs 49.7%, P = .001; C vs D = 62.7% vs 48.9%, P = .003). CONCLUSION: Stent-assisted aneurysm treatment resulted in higher total occlusion rates than non-stent-assisted treatment, with acceptable, comparable periprocedural event rates.
AB - BACKGROUND: Whether the addition of stenting to intracranial aneurysm coil embolization results in benefit in terms of occlusion rates or additional risk in terms of periprocedural adverse events is not clear. OBJECTIVE: To report retrospectively analyzed results of endovascular aneurysm treatment comparing stent-assisted coiling with coiling without stents at our hospital from 2005 to 2009. METHODS: In this retrospectively reviewed case series, aneurysms were grouped as intent-to-treat or initially treated with stent-assisted coiling (A) vs coiling alone (B) or as-treated - those that ultimately received a stent (C) or not (D). Complication and occlusion rates were compared between groups. Some patients crossed fromgroup B to C after receiving stent placement at a later treatment following the initial therapeutic modality (without a stent). RESULTS: In 459 patients, 489 aneurysms were treated by group as follows: A = 181, B = 308, C = 225, and D = 264. In stent groups (A and C), there were significantly lower frequencies of ruptured aneurysms (A vs B = 11% vs 62%, P < .001; C vs D = 20.4% vs 62.5%, P < .001) and more giant aneurysms (A vs B = 7.3% vs 1.0%, P = .001; C vs D = 5.9% vs 1.1%, P < .001). There was no statistically significant difference in permanent event-related morbidity (A vs B = 4.4% vs 4.2%, P = 1.0; C vs D = 4.4% vs 4.2%, P = 1.0). Average angiographic follow-up after last treatment was 18.2 ± 15 months (median = 14). Higher rates of complete occlusion at last angiographic follow-up were observed in stented aneurysms (A vs B = 64.6% vs 49.7%, P = .001; C vs D = 62.7% vs 48.9%, P = .003). CONCLUSION: Stent-assisted aneurysm treatment resulted in higher total occlusion rates than non-stent-assisted treatment, with acceptable, comparable periprocedural event rates.
KW - Cerebral aneurysms
KW - Complications
KW - Endovascular
KW - Occlusion
KW - Stent-assisted treatment
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U2 - 10.1227/NEU.0b013e31827b93ea
DO - 10.1227/NEU.0b013e31827b93ea
M3 - Article
C2 - 23149972
AN - SCOPUS:84879905773
SN - 0069-4827
VL - 72
SP - 232
EP - 239
JO - Clinical Neurosurgery
JF - Clinical Neurosurgery
IS - 2
ER -