Objective To evaluate predictors of unfavorable outcome in stent-assisted coiling for symptomatic unruptured intracranial spontaneous vertebral artery dissecting aneurysms (uis-VADAs) based on 608 reconstructed lesions in 30 medical centres.
Methods A total of 608 patients (male:female=479:129; mean age, 53.26±10.26 years) with 608 symptomatic uis-VADAs underwent reconstructive treatments using stent(s) with coils between January 2009 and December 2015. Treatments and predictors of unfavorable outcomes were retrospectively analyzed.
Results Mainly, three methods were used to treat patients with uis-VADAs, including routine single-stent in 208 patients (such as Enterprise and others), new low-profile LVIS single stent in 107 patients, and multiple stents in 293 patients. During the median 66 months of clinical follow-up, 14 patients died, and 16 of the remaining 594 survivors had unfavorable outcomes (modified Rankin Scale score 3–5). The overall mortality rate was 2.3% (14/608), and the unfavorable outcome (mRS score 3–6) rate was 4.9% (30/608). Multivariate logistic regression analysis indicated that preprocedural ischemic infarctions (OR=3.78; 95% CI 1.52 to 9.40; p<0.01), diabetes mellitus (OR=3.74; 95% CI 1.31 to 10.68; p=0.01), and procedural complications (OR=14.18; 95% CI 5.47 to 36.80; p<0.01) were predictors of unfavorable outcome in the reconstructed VADAs.
Conclusions This multicenter study indicated that preprocedural ischemic infarctions, diabetes mellitus, and procedural complications were related to unfavorable clinical outcomes in the reconstructed uis-VADAs.
Data availability statement
Data are available upon reasonable request. No.
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KZ and RZ contributed equally.
Contributors All authors participated in collection of data, KZ and RZ drafted and revised the article, XY and JL revised the article, and KZ performed the statistic analysis. Correspondence to JL and XY.
Funding This study was funded by Discipline Climbing Scheme (2019YXK023, 2019YXK030) and National Research and Development Project of Key Chronic Diseases (2016YFC1300700), the Outstanding Leaders Training Program and the Key Discipline Construction Project of Pudong Health Bureau of Shanghai (PWR12018-07, PWZxk2017-23).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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