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Original research
Follow-up outcomes of intracranial aneurysms treated using braided or laser-cut stents with closed-cell design: a propensity score-matched case-controlled comparison
  1. JeongWook Lim1,
  2. Young Dae Cho2,
  3. Noah Hong3,
  4. Jeongjun Lee4,
  5. Dong Hyun Yoo2,
  6. Hyun-Seung Kang3
  1. 1 Department of Neurosurgery, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, South Korea
  2. 2 Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea
  3. 3 Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
  4. 4 Department of Neurosurgery, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, South Korea
  1. Correspondence to Dr Young Dae Cho, Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea (the Republic of); aronnn{at}naver.com

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.

  • aneurysm
  • coil
  • stent

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors YDC: study design, data interpretation, statistical analysis, drafting the manuscript, and critical revision of the manuscript. JWL: data collection, data analysis, and manuscript drafting. JL, NH, DHY, H-SK: data collection and critical revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

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