Comparison of Clinical Outcomes After Stent-Assisted Coiling with 3 Types of Self-Expanding Laser-Cut Stents in Patients with Wide-Necked Intracranial Aneurysms

Autor: Katharina Otani, Shota Kakizaki, Ken Aoki, Toshihiro Ishibashi, Fumiaki Maruyama, Ayako Ikemura, Issei Kan, Ichiro Yuki, Tomonobu Kodama, Yuichi Murayama, Gota Nagayama, Shogo Kaku, Naoki Kato, Kengo Nishimura, Shota Sonoda
Rok vydání: 2020
Předmět:
Male
Reoperation
medicine.medical_specialty
Middle Cerebral Artery
Anterior Cerebral Artery
medicine.medical_treatment
Kaplan-Meier Estimate
Aneurysm
Ruptured
Postoperative Hemorrhage
Stent assisted coiling
03 medical and health sciences
0302 clinical medicine
Aneurysm
Postoperative Complications
Aneurysm treatment
medicine
Humans
In patient
cardiovascular diseases
Vertebral Artery
Aged
Proportional Hazards Models
Retrospective Studies
Posterior Cerebral Artery
Rupture
Spontaneous
business.industry
Endovascular Procedures
Stent
Intracranial Aneurysm
Cerebral Infarction
Middle Aged
medicine.disease
Embolization
Therapeutic
Confidence interval
030220 oncology & carcinogenesis
Relative risk
Basilar Artery
Surgery
Female
Stents
Neurology (clinical)
Radiology
Complication
business
Intracranial Hemorrhages
030217 neurology & neurosurgery
Carotid Artery
Internal
Zdroj: World neurosurgery. 146
ISSN: 1878-8769
Popis: Objective We report the clinical outcomes of stent-assisted coiling for wide-necked intracranial aneurysms using 3 low-profile laser-cut stents and compare the results according to stent type. Methods All patients treated with stent-assisted coiling for their intracranial aneurysms at our hospital between July 2010 and September 2019 were reviewed. We selected patients with Enterprise, Neuroform EZ, or Neuroform Atlas stents who underwent imaging follow-up and investigated aneurysm and stent features, stent-related complications, recanalization, and retreatment rates. We compared the retreatment risk among the patients treated with the 3 stent types using Kaplan-Meier survival analysis and Cox regression analysis. Results We evaluated 364 consecutive cases (103 Enterprise, 105 Neuroform EZ, and 156 Neuroform Atlas stents). Neuroform Atlas was more frequently used in distal vessels: 8 (7.8%) Enterprise, 2 (1.9%) Neuroform EZ, and 41 (26.3%) Neuroform Atlas cases, respectively. The median follow-up durations were 6.49, 4.91, and 1.24 years for the Enterprise, Neuroform EZ, and Neuroform Atlas cases, respectively, and retreatment was performed in 11 (10.1%), 9 (8.6%), and 6 (3.8%) cases. In the first 2 years of follow-up, the estimated retreatment risk ratios for Neuroform EZ and Neuroform Atlas with Enterprise as reference were 0.63 (95% confidence interval, 0.24–1.65; P = 0.35) and 0.54 (95% confidence interval, 0.18–1.59; P = 0.26), respectively. Conclusions Neuroform Atlas stents were more frequently deployed in small-caliber vessels compared with the other 2 types of stents. The complication rate and retreatment risk until at least 1 year after the aneurysm treatment appeared to be similar for the 3 stent types.
Databáze: OpenAIRE
Externí odkaz: