Results of stent-assisted vs non-stent-assisted endovascular therapies in 489 cerebral aneurysms: Single-center experience

Shady Jahshan, Adib A. Abla, Sabareesh K. Natarajan, Patrick S. Drummond, Peter Kan, Yuval Karmon, Kenneth V. Snyder, L. Nelson Hopkins, Adnan H. Siddiqui, Elad I. Levy

Research output: Contribution to journalArticle

46 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)232-239
Number of pages8
JournalClinical Neurosurgery
Volume72
Issue number2
DOIs
StatePublished - 2013

Keywords

  • Cerebral aneurysms
  • Complications
  • Endovascular
  • Occlusion
  • Stent-assisted treatment

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Jahshan, S., Abla, A. A., Natarajan, S. K., Drummond, P. S., Kan, P., Karmon, Y., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2013). Results of stent-assisted vs non-stent-assisted endovascular therapies in 489 cerebral aneurysms: Single-center experience. Clinical Neurosurgery, 72(2), 232-239. https://doi.org/10.1227/NEU.0b013e31827b93ea