The Association of Different Stenting Procedures with Symptomatic Thromboembolic Complications in Stent-Assisted Coiling of Ruptured Wide-necked Intracranial Aneurysms.

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The Association of Different Stenting Procedures with Symptomatic Thromboembolic Complications in Stent-Assisted Coiling of Ruptured Wide-necked Intracranial Aneurysms.

World Neurosurg. 2017 May 25;:

Authors: Cai K, Ji Q, Cao M, Shen L, Xu T, Zhang Y

Abstract
OBJECTIVE: This study aimed to evaluate the association of different stenting procedures with the procedure-related complications in stent-assisted coiling (SAC) of ruptured wide-necked aneurysms.
METHODS: Consecutive patients undergoing SAC of ruptured wide-necked aneurysms were retrospectively reviewed between December 2011 and June 2016. They received one of the three stenting procedures during SAC: 1) the coiling microcatheter was "jailed" outside of the stent and the coil embolization proceeded above the stent; 2) initial stent deployment followed by the coils through the stent's strut technique; or 3) the coil then stent technique. The effect of different stenting procedures on clinical complications and outcomes was estimated by logistic regression models.
RESULTS: Of the 93 patients enrolled in this study, 11 (11.8%) suffered from symptomatic thromboembolic events and 10 (10.8%) hemorrhagic complications. SAC with different stenting procedures (Odds Ratio [OR] =4.10, 95% Confidence Interval [CI]: 1.20-13.97, P=0.024) was the only independent risk factor for symptomatic thromboembolic events. The coil then stent technique had higher ischemic complications rate than had the other two stenting procedures (P=0.023). Serum glucose (OR=1.48, P =0.014) and systolic blood pressure on admission (OR=0.97, P =0.046) were independent predictors of hemorrhagic complications during SAC. However, different stenting procedures and stent types were correlated neither aneurysm occlusion at the end of procedure ((P=0.498 and 0.176, respectively) nor favorable outcome at discharge (P=0.710 and 0.928, respectively).
CONCLUSION: Different stenting procedures were associated with thromboembolic but not hemorrhagic complications in SAC of ruptured wide-necked aneurysms.

PMID: 28552737 [PubMed - as supplied by publisher]

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