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Total Stent-Assisted No Stent P No. of aneurysms 1815 323 1492 – Age, y, mean ± SD 50.5 ± 12.9 51.8 ± 11.5 50.3 ± 13.1 .009 Ruptured aneurysm, n (%) 767 (42.3) 38 (11.8) 729 (48.9) <.0001 Female, n (%) 986 (65.5) 196 (68.8) 790 (64.8) .20 Location, n (%) ICA 647 (35.6) 134 (41.5) 513 (34.4) .015 MCA 489 (26.9) 94 (29.1) 395 (26.5) .34 AcomA 446 (24.6) 49 (15.2) 397 (26.6) <.0001 Vertebrobasilar 160 (8.8) 42 (13.0) 118 (7.9) .003 Pericallosal 59 (3.3) 2 (0.6) 57 (3.8) .003 PCA 14 (0.8) 2 (0.6) 12 (0.8) .73 Aneurysm size, mm, mean ± SD 7.1 ± 4.0 8.2 ± 4.7 6.8 ± 3.8 <.0001 Neck size, mm, mean ± SD 3.8 ± 1.9 5.0 ± 2.6 3.6 ± 1.6 <.0001 Multiple, n (%) 1078 (59.4) 147 (45.5) 931 (62.4) .004 AVM-related, n (%) 36 (2.0) 2 (0.6) 34 (2.3) .052 No. of procedures 1699 299 1400 – No. of aneurysms treated in same EVT, n (%) 1 1591 (93.6) 275 (92.0) 1316 (94.0) 2 100 (5.9) 24 (8.0) 76 (5.4) 3 8 (0.5) 0 8 (0.6) Balloon-assisted, n (%) 1017 (56.0) 149 (46.1) 868 (58.2) <.0001 Packing density, %, mean ± SD 26.8 ± 12.3 24.6 ± 11.1 27.3 ± 12.5 <.0001 Note:—AcomA indicates anterior communicating artery; EVT, endovascular treatment; PCA, posterior cerebral artery.
Total Stent-Assisted No Stent P Immediate result, n (%) (n = 1815) (n = 323) (n = 1492) – Class 1a 1083 (59.7) 165 (51.1) 918 (61.5) <.001 Class 2b 307 (16.9) 44 (13.6) 263 (17.6) .08 Class 3c 425 (23.4) 114 (35.3) 311 (20.8) <.0001 Last follow-up result, n (%) (n = 1254) (n = 207) (n = 1047) – Class 1a 718 (57.3) 152 (73.4) 566 (54.1) <.0001 Class 2b 319 (25.4) 30 (14.5) 289 (27.6) <.0001 Class 3c 217 (17.4) 25 (12.1) 192 (18.3) .04 Total Stent-Assisted No Stent P No. of aneurysms followed 1254 207 1047 – Cumulative follow-up, mo, median (range) 20.0 (1–122) 16.0 (1–69) 21.0 (1–122) .0004 Recurrence, n (%) 404 (32.2) 32 (15.5) 372 (35.5) <.0001 Univariate P Relative Risk 95% CI Logistic Regression P Younger age .004 .008 Location ICA .056 0.84 0.70–1.00 MCA .72 1.04 0.86–1.25 AcomA .39 1.09 0.90–1.32 Vertebrobasilar .82 1.05 0.78–1.37 Pericallosal .054 1.50 0.99–2.03 PCA .50 0.56 0.10–1.63 Sac size <.0001 <.00001 Neck size .001 .02 Packing density .013 .005 Cumulative follow-up period .33 Balloon-assisted .82 0.98 0.83–1.16 SAH <.0001 1.72 1.46–2.02 <.00001 No stent <.0001 2.30 1.65–3.28 <.00001 Note:—AcomA indicates anterior communicating artery; PCA, posterior cerebral artery.
Univariate P Logistic Regression P Sac size <.001 <.001 Stent .084 .0039 SAH .098 .0024 Packing density <.001 .019 Initial occlusion <.001 <.001 Total Stent-Assisted No Stent χ2 No. of procedures 1699 299 1400 – Complications, n (%) 107 (6.3) 28 (9.4) 79 (5.6) 0.016a Ischemia 70 (4.1) 21 (7.0) 49 (3.5) 0.005a Hemorrhage 34 (2.0) 7 (2.3) 27 (1.9) 0.64 Hydrocephalus 3 (0.2) 0 3 (0.2) 0.42 Complication-related deaths, n (%) 23 (1.4) 8 (2.7) 15 (1.1) 0.029a ↵a Significant value.
Univariate P Relative Risk 95% CI Logistic Regression P Age .16 Location MCA .01 1.67 1.15–2.43 .058 Vertebrobasilar .08 0.40 0.15–1.07 – ICA .84 0.94 0.64–1.38 – AcomA .48 0.83 0.53–1.30 – Pericallosal 1.00 0.85 0.28–2.50 – PCA .71 NA – No. of aneurysms in same EVT (multiple vs single) .98 1.04 0.58–1.79 – Size .04 .94 Neck <.001 .02a Balloon-assisted 1.00 1.02 0.70–1.47 – SAH .98 1.01 0.70–1.47 – Stent .016 1.66 1.07–2.55 0.15 Single (vs Y) stenting .36 1.59 0.73–3.47 – Note:—AcomA indicates anterior communicating artery; EVT, endovascular treatment; NA, not available for the small sample numbers; PCA, posterior cerebral artery.
↵a Significant value.
Case/Sex/Age Presentation Use of Antiplatelet Initial Aneurysm Occlusion Stent (Re)-Bleeding Delay Outcome (mRS) 1/F/71 SAH None 1 None Day 1 6 2/F/68 Fortuitous None 1 None 12 mo 4 3/M/46 SAH None 3 None Day 10 6 4/F/48 SAH None 3 None Day 10 6 5/F/65 SAH 8 mg i.a. of abciximab during procedure 1 None Hour 14 6 6/F/57 SAH None 1 None Day 1 4 7/M/35 SAH None 1 None Hour 6 6 8/M/48 SAH None 3 None Hour 8 6 9/F/55 SAH None 3 None 89 mo 6 10/F/37 SAH None 2 None 57 mo 6 11/F/52 SAH None 1 None 17 mo 1 12/F/81 SAH None 3 None Day 4 6 13/F/55 SAH None 3 None 4 mo 6 14/M/52 Fortuitous Clopidogrel + aspirin 2 Yes 12 mo 1 15/M/41 SAH None 1 None Day 18 6 16/M/52 SAH 4 mg i.a. of abciximab during procedure 1 None Day 1 6 17/F/51 SAH 4 mg i.a. of abciximab during procedure 1 None Hour 4 6 18/M/20 SAH No 1 None Day 22 1 19/M/69 Fortuitous Clopidogrel + aspirin 1 Yes Day 21 6 20/F/56 SAH No 3 None Day 1 6 21/F/56 SAH No 3 None 2 mo 1 Note:—i.a. indicates intra-arterial.
Analysis of Complications and Recurrences of Aneurysm Coiling with Special Emphasis on the Stent-Assisted Technique
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