Stent-assisted coiling and balloon-assisted coiling in the management of intracranial aneurysms: A systematic review & meta-analysis

J Neurol Sci. 2016 May 15:364:160-6. doi: 10.1016/j.jns.2016.03.041. Epub 2016 Mar 25.

Abstract

Background: Stent-assisted coiling and balloon-assisted coiling are well-established minimally invasive techniques for treatment of intracranial aneurysms. The aim of this study was to use meta-analysis methods to compare clinical outcomes of aneurysms treated with stent-assisted coiling versus balloon-assisted coiling.

Methods: We searched for two-arm prospective studies and retrospective studies that compared the clinical outcomes in patients that received stent-assisted or balloon-assisted aneurysm treatment. Database search was performed through May 2015. Odds ratios (OR) with 95% confidence intervals (CI) were used to compare the clinical outcomes in patients that underwent either stent-assisted or balloon-assisted coiling for intracranial aneurysms management.

Results: Complete occlusion rates at the end of the coiling procedure were similar between patients that received stent-assisted and balloon-assisted aneurysm treatment (OR=0.763, 95% CI=0.47 to 1.23, P=0.270). However, complete occlusion rates were higher with stent-assisted coiling at 6months or later after the procedure (OR=1.82, 95% CI=1.21 to 2.74). The overall complication rates and retreatment rates in patients with recurrence were similar between stent-assisted and balloon-assisted aneurysm treatments.

Conclusion: Stent-assisted coiling achieved better complete occlusion rates of aneurysms at 6months or later after the procedure compared to balloon-assisted coiling, without being associated with a higher risk of intraprocedural complications and retreatment.

Keywords: Aneurysm; Balloon-assisted coiling; Stent-assisted coiling.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Balloon Occlusion / instrumentation
  • Balloon Occlusion / methods
  • Disease Management*
  • Embolization, Therapeutic / instrumentation*
  • Embolization, Therapeutic / methods*
  • Humans
  • Intracranial Aneurysm / therapy*
  • Stents*