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Results of Stent-assisted versus Non-stent-assisted Endovascular Therapies in 489 Cerebral Aneurysms: Single-Center Experience.
MedLine Citation:
PMID:  23149972     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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 to coiling without stents at our hospital from 2005-2009. METHODS:: In this retrospectively reviewed case series, aneurysms were grouped as intent-to-treat or initially treated with stent-assisted coiling (A) versus 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 from group 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, D=264. In stent groups (A&C), there were significantly lower frequencies of ruptured aneurysms (A vs. B=11% vs. 62%,P<0.0001;C vs. D=20.4% vs. 62.5%,P<0.0001) and more giant aneurysms (A vs. B=7.3% vs. 1.0%,P=0.0001; C vs. D=5.9% vs. 1.1%,P<0.0001). 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=0.0014; C vs. D=62.7% vs. 48.9%,P=0.0026). CONCLUSION:: Stent-assisted aneurysm treatment resulted in higher total occlusion rates than non-stent-assisted treatment, with acceptable, comparable periprocedural event rates.
Authors:
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
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-10
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Departments of Neurosurgery and 2Radiology and 3Toshiba Stroke Research Center School of Medicine and Biomedical Sciences,4 University at Buffalo, State University of New York Department of Neurosurgery,5 Gates Vascular Institute, Kaleida Health Jacobs Institute,6 Buffalo, New York, USA.
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