Safety and efficacy of stent-assisted coiling ruptured intracranial aneurysms: A single-center experience

Author:

Zhang Deng-Xiang1,Luo Chao-Bao23,Lee Chien-Hui1

Affiliation:

1. Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan

2. Department of Radiology, Taipei Veterans General Hospital and School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

3. Department of Radiology, Tri-Service General Hospital and National Defenses Medical Center, Taipei, Taiwan

Abstract

ABSTRACT Objective: Endovascular coiling is a minimally invasive method to manage intracranial aneurysms. However, patients who undergo stent-assisted coiling (SAC) for acutely ruptured intracranial aneurysms need dual antiplatelet treatment. We reported our experience and outcomes of SAC for ruptured intracranial aneurysm. Materials and Methods: We retrospectively collected data on procedure-related complications, rates of aneurysm rebleeding and recurrence, and clinical outcomes of patients with ruptured aneurysms managed by SAC over 2 years. Results: Among the 17 patients included in this study, there were 14 (82.4%) women and 3 (17.6%) men, with a mean age of 58.59 years (standard deviation = 13.57; range: 40–82 years). There were no periprocedural hemorrhagic complications and no aneurysm rebleeding before discharge. However, two patients developed acute brain infarction because of symptomatic vasospasm. Linear regression revealed significant associations of posterior circulation involvement with the Glasgow Outcome Score and modified Rankin Scale (mRS) at discharge and 6 months after. Besides, Hunt and Hess grade ≥3 has a significant association with mRS at discharge, 6 months, and 1 year after. Conclusion: SAC for ruptured aneurysm was technically feasible and did not carry an additional risk of postoperative aneurysm rebleeding secondary to antiplatelet treatment. Moreover, it had relatively low rates of aneurysm regrowth and coil compaction. Therefore, it can be a safe and effective endovascular treatment for acutely ruptured intracranial aneurysm.

Publisher

Medknow

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