RT Journal Article
SR Electronic
T1 A core-lab adjudicated analysis of single-stent assisted coiling of wide-neck bifurcation aneurysms
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP jnis-2023-020995
DO 10.1136/jnis-2023-020995
A1 Siddiqui, Aliya
A1 Fargen, Kyle M
A1 Vranic, Justin E
A1 Patel, Aman B
A1 Ogilvy, Christopher S
A1 Thomas, Ajith J
A1 Mascitelli, Justin R
A1 Fifi, Johanna T
A1 Mocco, J
A1 De Leacy, Reade Andrew
YR 2024
UL http://jnis.bmj.com/content/early/2024/07/03/jnis-2023-020995.abstract
AB Background and purpose Core-lab adjudicated data regarding the efficacy of the single-stent assisted aneurysm coiling technique ‘L-stenting’ are lacking. We present a multicenter, core-lab adjudicated study evaluating the safety and effectiveness of single-stent assisted coiling in the treatment of wide-neck bifurcation aneurysms (WNBAs).Methods Consecutive patients who underwent L-stenting for WNBAs at three academic institutions between 2015 and 2019 were included in this retrospective study. Clinical safety and efficacy outcomes were gathered from the patient chart, and angiographic imaging was evaluated by core lab analysis. Safety and efficacy outcomes were summarized and predictors of safety and efficacy were calculated.Results Of 128 patients treated, 124 had angiographic outcome data at last follow-up. Of those, 110 had adequate (core-lab adjudicated modified Raymond Roy (mRR) score of 1 or 2) occlusion (88.7%). During follow-up, 19 patients (14.8%) required retreatment. There were 17 complications experienced in 12 patients: intraoperative (n=8, 6.25%), perioperative (n=5, 3.9%), or delayed (n=6; n=4 attributed to device/procedure, 3.1%). Significant predictors of complete occlusion were smaller aneurysm size and use of the jailing technique (P=0.0276). Significant predictors of retreatment were larger size, neck size, and larger dome to neck ratio (P=0.0008).Conclusion This study provides multicenter, core-lab adjudicated angiographic data regarding the efficacy of single-stent assisted coiling for WNBAs. This study acts as a validated comparator for future studies investigating novel devices or techniques for treating this challenging subgroup of aneurysms.Data are available upon reasonable request. Please contact reade.deleacy@mountsinai.org for data.