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Safety and Effectiveness of Stent-Assisted Coil Embolization for ruptured intracranial aneurysm

Open Journal of Modern Neurosurgery 2024年第4期14卷 275-283页

作者： Bibang Ndong Virginio Shichao Zhang Wenfeng Feng Mingzhou Li Gang Wang Huibin Kang Yunyu Wen Yu Ye Mesi Ndong Edo Euvaldo Songtao Qi Guozhong Zhang Department of Neurosurgery Nanfang Hospital Southern Medical University Guangzhou China Department of Neurosurgery Shenzhen Longgang Central Hospital Shenzhen China Equatorial Guinea Commission for Scientific and Technological Research (CICTE) Malabo Equatorial Guinea

Background: It has been conclusively established that intracranial aneurysms measuring a diameter below 7 mm pose a minimal risk of rupture. Conversely, those exhibiting irregular morphology or featuring the presence of a sac necessitate a more stringent and rigorous management approach. Objective: The primary aim of this study is to delve into the morphological features of ruptured aneurysms situated in distinct regions of the brain. Furthermore, we endeavor to assess the degree of safety and efficacy associated with stent-assisted embolization as a treatment modality for these ruptured aneurysms. Methods: This retrospective study encompassed a cohort of 467 patients who presented with intracranial ruptured aneurysms and were diagnosed through a combination of computed tomography (CT) and digital subtraction angiography (DSA) at Nanfang Hospital of Southern Medical University, spanning from January 2009 to December 2019. The following clinical parameters were meticulously recorded: aneurysm height, width, neck measurements, immediate Raymond grade assessments, and any perioperative complications experienced. Results: Within the study population, the average dimensions of ruptured aneurysms were found to be 4.26 ± 2.10 mm (width), 4.86 ± 2.38 mm (height), and 4.04 ± 1.87 mm (neck). Categorically, the most prevalent types of aneurysms were 170 cases of anterior communicating artery aneurysms (accounting for 36.4%), followed by 161 cases of posterior communicating artery aneurysms (34.5%), 56 cases of middle cerebral artery aneurysms (12.0%), 13 cases of anterior cerebral artery aneurysms (2.8%), 45 cases of paraclinoid aneurysms (9.6%), 6 cases of superior pituitary artery aneurysms (1.3%), 7 cases of anterior choroidal artery aneurysms (1.5%), and 9 cases of vertebrobasilar artery aneurysms (2.0%). Notably, 18 patients (3.9%) presented with ruptured aneurysms coexisting with ascus. Regarding treatment approaches, 228 cases (48.8%) underwent stent-assisted embolizati

关键词： ruptured intracranial aneurysm Interventional Therapy Stent Assisted Embolization

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Safety and efficacy of stent-assisted coiling for acutely ruptured wide-necked intracranial aneurysms:comparison of LVIS stents with laser-cut stents

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Chinese Neurosurgical Journal 2021年第2期7卷 116-125页

作者： Gaici Xue Qiao Zuo Xiaoxi Zhang Haishuang Tang Rui Zhao Qiang Li Yibin Fang Pengfei Yang Bo Hong Yi Xu Qinghai Huang Jianmin Liu Department of Neurosurgery General Hospital of Southern Theatre Command of PLA111 Liuhua RoadGuangzhou 510010China Department of Neurosurgery Changhai HospitalNaval Medical University168 Changhai RoadShanghai 200433China

Background:To compare the safety and efficacy of LVIS stent-assisted coiling with those of laser-cut stent-assisted coiling for the treatment of acutely ruptured wide-necked intracranial ***:Patients with acutely ruptured wide-necked intracranial aneurysms treated with LVIS stent-assisted coiling(LVIS stent group)and laser-cut stent-assisted coiling(laser-cut stent group)were retrospectively reviewed from January 2014 to December *** score matching was used to adjust for potential differences in age,sex,aneurysm location,aneurysm size,neck width,Hunt-Hess grade,and modified Fisher *** procedure-related complications and clinical and angiographic follow-up outcomes were *** and multivariate analyses were performed to determine the associations between procedure-related complications and potential risk ***:A total of 142 patients who underwent LVIS stent-assisted coiling and 93 patients who underwent laser-cut stent-assisted coiling were enrolled after 1:2 propensity score *** angiographic follow-up outcomes showed that the LVIS stent group had a slightly higher complete occlusion rate and lower recurrence rate than the laser-cut stent group(92.7%vs 80.6%;3.7%vs 9.7%,P=0.078).The clinical outcomes at discharge and follow-up between the two groups demonstrated no significant differences(P=0.495 and P=0.875,respectively).The rates of intraprocedural thrombosis,postprocedural thrombosis,postoperative early rebleeding,and procedure-related death were 0.7%(1/142),1.4%(2/142),2.8%(4/142),and 2.1%(3/142)in the LVIS stent group,respectively,and 4.3%(4/93),2.2%(2/93),1.1%(1/93),and 3.2%(3/93)in the laser-cut stent group,respectively(P=0.082,0.649,0.651,and 0.683).Nevertheless,the rates of overall procedure-related complications and intraprocedural rupture in the LVIS stent group were significantly lower than those in the laser-cut stent group(5.6%vs 14.0%,P=0.028;0.7%vs 6.5%,P=0.016).Multivariate an

关键词： ruptured intracranial aneurysm LVIS stent Laser-cut stent Propensity score matching

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