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Original research
Long term follow-up of bifurcation aneurysms treated with braided stent assisted coiling and complex T- and Y- stent constructs
  1. Nicholas K Cheung1,
  2. Albert HY Chiu2,3,4,
  3. Andrew Cheung2,4,3,
  4. Jason D Wenderoth2,4,3
  1. 1Department of Medical Imaging, Royal Hobart Hospital, Tasmania, Australia
  2. 2Department of Interventional Neuroradiology, Prince of Wales Hospital, New South Wales, Australia
  3. 3Department of Interventional Neuroradiology, Prince of Wales Private Hospital, New South Wales, Australia
  4. 4Department of Interventional Neuroradiology, Liverpool Hospital, New South Wales, Australia
  1. Correspondence to Dr Jason D Wenderoth, Suite 19, Level 7, Prince of Wales Private Hospital, Barker Street,Randwick, NSW 2031, Australia; dwenderoth{at}gmail.com

Abstract

Background Stent assisted coil embolization (SACE) of bifurcation aneurysms is challenging. Heterogeneous results have been achieved to date, but largely for laser cut stents. While braided stents offer multiple technical advantages, their long term efficacy has yet to be validated.

Objective To report the first long term 18 month results for the durability of bifurcation aneurysms treated with braided stents.

Materials and methods Over a 4 year period, 59 consecutive patients with 60 bifurcation aneurysms underwent elective braided SACE across three Australian neurovascular centers. 17 of these aneurysms underwent T- or Y-shaped stent constructs. All patients had immediate, 6 month and 18 month clinical and radiological follow-up. Radiological assessment was made on modified Raymond–Roy occlusion scores while clinical assessment was based on the modified Rankin Scale. Subgroup analysis of 17 aneurysms treated with multi-stent constructs was conducted.

Results 6 month follow-up data were available for 59 aneurysms and 18 month follow-up data for 58 aneurysms. Satisfactory aneurysm occlusion was achieved in 97% at inception and at 6 months, and 98% at 18 months. Good neurological outcomes were achieved in 95% at 18 months. Similar satisfactory results were achieved with the multi-stent construct cohort. Intraprocedural thromboembolic events were recorded in 5% and delayed events in 2%. Technical complications were found in 5%. All complication rate was 13%.

Conclusion Braided SACE was safe, efficacious, and durable at the long term 18 month follow-up, including for multi-stent constructs. Preliminary results indicate favorable clinical and radiological outcomes compared with laser cut stents.

  • coil
  • aneurysm
  • stent
  • angiography
  • intervention

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Footnotes

  • Contributors All authors contributed to the planning and conducting of the research.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study was approved by the National Health and Medical Research Council, Australian Research Council.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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