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Original research
Stent-assisted coiling of cerebral aneurysms: a single-center clinical and angiographic analysis
  1. Jun Wang1,2,
  2. Jan Vargas2,
  3. Alejandro Spiotta2,
  4. Imran Chaudry2,
  5. Raymond D Turner2,
  6. Jonathan Lena2,
  7. Aquilla Turk2
  1. 1Department of Neurology, General Hospital of PLA, Beijing, China
  2. 2Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  1. Correspondence to Dr Aquilla Turk, 96 Jonathan Lucas Street, CSB 301, Charleston, SC, USA; turk{at}musc.edu

Abstract

Objective This study retrospectively compared the clinical and angiographic outcomes of treating cerebral aneurysms with Neuroform (NEU), Enterprise (EP), and Low-profile Visualized Intraluminal Support (LVIS/LVIS Jr) stents.

Materials and methods We conducted a retrospective analysis of a procedural database. All aneurysm procedures using any of the three types of self-expanding nitinol stents (NEU, EP and LVIS/LVIS Jr) were included. Intra-procedure complications, post-procedure complications, and angiographic results (Raymond–Roy grade scale, RRGS) were analyzed retrospectively. A multivariate logistic regression analysis was conducted to identify predictors of intra-procedure and post-procedure complications.

Results Two hundred and forty-three aneurysms in 229 patients treated with stent-assisted coiling were included (NEU group: 109 aneurysms; EP group: 61 aneurysms; LVIS/LVIS Jr: 73 aneurysms). The LVIS/LVIS Jr group was associated with the lowest rate of initial complete occlusion (RRGS I: 47.9%; 35/73). Follow-up showed the proportion of RRGS I increased for all stent groups but was greatest in the LVIS/LVIS Jr group. Overall, 17 intra-procedural complications were seen in 229 patients (7.4%) and 15 post-procedural complications were found in 198 patients at follow-up (7.6%), with no differences between stent groups. Thrombotic events were the most common complications and occurred in 13 patients (13/229, 5.7%).

Conclusions All three types of stents used to treat cerebral aneurysms with unfavorable neck were safe and effective, providing suitable support for the coil mass. LVIS/LVIS Jr promotes better progressive aneurysm complete occlusion than the other two stents but seems to cause more common intra-procedural stent-related thrombotic events and fewer post-procedural complications.

  • aneurysm
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Footnotes

  • Contributors Design and revising of the work: AT. Drafting the work and analysis, interpretation of data: JW. Acquisition of data: JV, AS, IC, RDT, JL. Final approval of the version to be published: AT. Agreement to be accountable for all aspects of the work: all authors.

  • Competing interests AS: Penumbra: Consulting, Honorarium, Speaker Bureau; Pulsar Vascular: Consulting, Honorarium, Speaker Bureau; Microvention: Consulting, Honorarium, Speaker Bureau, Research; Stryke:r Consulting, Honorarium, Speaker Bureau. RDT, AT, IC: Codman: Consulting, Honorarium, Speaker Bureau, Research funding; Covidien: Consulting, Honorarium, Speaker Bureau; Penumbra: Consulting, Honorarium, Speaker Bureau, Research grants; Microvention: Consulting, Honorarium, Speaker Bureau, Research grants; Blockade: Stock, Consulting, Honorarium, Speaker Bureau; Pulsar Vascular: Stock, Consulting, Honorarium, Speaker Bureau, Research; Medtronic: Consulting, Honorarium, Speaker Bureau.

  • Ethics approval Medical University of South Carolina IRB.

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

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