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Long-term follow-up of aneurysms treated electively with woven stent-assisted coiling
  1. Nicholas Kiu Cheung1,
  2. Albert HY Chiu,
  3. Andrew K Cheung,
  4. Jason David Wenderoth1,2,3
  1. 1Department of Interventional Neuroradiology, Prince of Wales Hospital, Randwick, NSW, Australia
  2. 2School of Medicine, University of NSW, Sydney, NSW, Australia
  3. 3Department of Interventional Neuroradiology, Liverpool Hospital, Liverpool, NSW, Australia
  1. Correspondence to Dr Jason David Wenderoth, Prince of Wales Hospital, Randwick, NSW, 61408280996, Australia; j.wenderoth{at}unsw.edu.au

Abstract

Background Preliminary short-term results for stent-assisted coil embolization (SACE) using woven/braided stents have been promising. However, evidence supporting mid- to long-term efficacy and durability is lacking.

Objective To report the long-term results for the durability of elective intracranial aneurysms treated with woven stents.

Materials and methods Between May 2012 and May 2015, 98 consecutive patients with 103 aneurysms underwent elective woven SACE across three Australian neurovascular centres. All patients had immediate, 6- and 18-month clinical and radiological follow-up. Radiological assessment was performed with modified Raymond–Roy occlusion scores based on angiography results, while clinical assessment was based on the modified Rankin Scale.

Results Six-month follow-up was available in 100 aneurysms, and an 18-month follow-up in 97 aneurysms. Total occlusion rates of 82% were achieved at inception, 82% at 6 months, and 90% at 18 months. Satisfactory occlusion with small neck remnants was present in 17% at inception, 16% at 6 months, and 9% at 18 months. Good neurological outcomes were achieved in 95% at 18 months. Intraprocedural thromboembolic events were recorded in 3% and delayed events in 1% (all in patients taking clopidogrel). Aneurysm recurrence occurred in one patient (1%). Technical complications occurred in 5%. The total complication rate was 10%.

Conclusions Woven SACE is safe, efficacious, and durable at long-term 18-month follow-up, with very low recurrence and re-treatment rates. Preliminary results appear better than those for traditional laser-cut stents.

  • Coil
  • aneurysm
  • stent
  • angioplasty

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Footnotes

  • Contributors All authors made substantial contributions to the design of the study, analysis and interpretation of data for the work. All authors drafted and/or revised it critically, and provided final approval of the version to be published; and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval National Health and Medical Research Council, Australian Research Council.

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

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