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Effect of stenting on progressive occlusion of small unruptured saccular intracranial aneurysms with residual sac immediately after coil embolization: a propensity score analysis
  1. Jin Pyeong Jeon1,
  2. Young Dae Cho2,
  3. Jong Kook Rhim2,
  4. Jeong Jin Park3,
  5. Won-Sang Cho4,
  6. Hyun-Seung Kang4,
  7. Jeong Eun Kim4,
  8. Moon Hee Han2,4
  1. 1Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Korea
  2. 2Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
  3. 3Department of Radiology, Sungkyunkwan University College of Medicine, Seoul, Korea
  4. 4Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
  1. Correspondence to Dr YD Cho, Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110–744, Korea; aronnn{at}naver.com

Abstract

Background To examine the effect of stenting on progressive occlusion of small and incompletely occluded unruptured intracranial aneurysms (UIAs) ≤10 mm in size using a propensity score matched case controlled analysis.

Methods 715 small UIAs consecutively treated by coiling between 2008 and 2010 were eligible for study. Time of flight MR angiography and/or catheter angiography were used to estimate extent of occlusion after coiling. Complete occlusion at 6 months post embolization of a sac filled with contrast immediately after coiling constituted progressive occlusion. A propensity score matched analysis was conducted, based on the probability of stent deployment.

Results 206 (28.8%) small UIAs showed residual sac filling directly after coiling. Of these, 182 (88.3%) displayed progressive occlusion at 6 months. Aneurysm size (p<0.01), neck size (p<0.01), and embolization attempt (p<0.01) differed significantly for stented and non-stented lesions, but the incidence of progressive occlusion did not differ (p=0.78) between the groups. After 1:1 propensity score matching, however, the rate of complete occlusion in stented subjects (97.5%) surpassed that of the non-stented counterparts (OR=9.75, p=0.01).

Conclusions Small UIAs with residual sac filling after coiling showed a complete occlusion rate of 88.3% at 6 months post embolization. Stent deployment seems to promote complete occlusion in such lesions.

  • Aneurysm
  • Angiography
  • Stent

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