Stent-Assisted Coiling May Prevent the Recurrence of Very Small Ruptured Intracranial Aneurysms: A Multicenter Study.

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Stent-Assisted Coiling May Prevent the Recurrence of Very Small Ruptured Intracranial Aneurysms: A Multicenter Study.

World Neurosurg. 2017 Jan 03;:

Authors: Zhang Y, Yang M, Zhang H, Zhang X, Li Y, Jiang C, Liu J, Yang X

Abstract
OBJECTIVE: To evaluate the safety and efficacy of endovascular treatments, including stent-assisted coiling, of very small (≤3 mm), ruptured intracranial aneurysms.
METHODS: Ninety-three endovascularly treated patients with very small ruptured aneurysms were recruited from four high-volume centers between September 2010 and February 2014. Factors influencing procedural complications and outcomes were analyzed.
RESULTS: Fifty-one (54.8%) aneurysms were treated by stent-assisted coiling, 41 (44.1%) by coiling alone, and 1 (1.1%) by balloon-assisted coiling. Intraprocedural or postprocedural complications occurred in 13 patients (14.0%): coil migration in one , intraprocedural rupture in one, hydrocephalus in six and ischemic event in one. No tested factor was able to predict procedural complications. Angiographic follow-up of 67 aneurysms (72%) revealed recurrence in five patients (7.5%). One recurrent case was treated initially by stent-assisted coiling and the remaining four by coiling alone (p=0.044). Multivariate regression analysis showed that coiling alone was significantly associated with aneurysm recurrence (odds ratio, 13.8; 95% confidence interval, 1.1-175.3; p=0.043).
CONCLUSIONS: Endovascular treatment of very small ruptured aneurysms was safe and effective and was not associated with a high rate of intraprocedural rupture. Treatment using stents significantly lowered the recurrence rate without additional risks.

PMID: 28062369 [PubMed - as supplied by publisher]

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