Author:
Lim JeongWook,Cho Young Dae,Hong Noah,Lee Jeongjun,Yoo Dong Hyun,Kang Hyun-Seung
Abstract
Background
The impact of various stents on patients with intracranial aneurysms
who undergo stent-assisted coiling has been debated. We conducted this
study to compare follow-up outcomes of coiling procedures involving
braided or laser-cut stents with closed-cell design. A propensity
score-matched case-controlled analysis was applied.
Methods
A total of 413 intracranial aneurysms consecutively coiled using
laser-cut (n=245) or braided stents (n=168) in procedures performed
between September 2012 and June 2017 were eligible for study.
Time-of-flight magnetic resonance angiography, catheter angiography, or
both were used to gauge occlusive status after coiling. Recanalization
was determined by Raymond classification (complete occlusion vs
recanalization). A propensity score-matched analysis was conducted,
based on probability of stent type in use.
Results
Ultimately, 93 coiled aneurysms (22.5%) showed some recanalization
(minor, 51; major, 42) during the follow-up period (mean 21.7±14.5
months). Patient gender (P=0.042), hyperlipidemia (P=0.015), size of
aneurysm (P=0.004), neck size (P<0.001), type of aneurysm
(P<0.001), and packing density (P=0.024) differed significantly by
group. Midterm and cumulative recanalization incidence rates in the
braided-stent group were initially lower than those of the laser-cut
stent group (P=0.009 and P=0.037, respectively) but they did not differ
significantly after 1:1 propensity score matching (midterm OR=0.88,
P=0.724; cumulative HR=0.91, P=0.758).
Conclusion
In stent-assisted coiling of intracranial aneurysms, laser-cut and
braided stent groups produced similar outcomes in follow-up.
Consequently, product selection may hinge on suitability for deployment
rather than anticipated results.
Subject
Neurology (clinical),General Medicine,Surgery
Cited by
11 articles.
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