World neurosurgery 2017 05 25() pii S1878-8750(17)30792-1
This study aimed to evaluate the association of different stenting procedures with the procedure-related complications in stent-assisted coiling (SAC) of ruptured wide-necked aneurysms.
Consecutive patients undergoing SAC of ruptured wide-necked aneurysms were retrospectively reviewed between December 2011 and June 2016. They received one of the three stenting procedures during SAC: 1) the coiling microcatheter was "jailed" outside of the stent and the coil embolization proceeded above the stent; 2) initial stent deployment followed by the coils through the stent’s strut technique; or 3) the coil then stent technique. The effect of different stenting procedures on clinical complications and outcomes was estimated by logistic regression models.
Of the 93 patients enrolled in this study, 11 (11.8%) suffered from symptomatic thromboembolic events and 10 (10.8%) hemorrhagic complications. SAC with different stenting procedures (Odds Ratio [OR] =4.10, 95% Confidence Interval [CI]: 1.20-13.97, P=0.024) was the only independent risk factor for symptomatic thromboembolic events. The coil then stent technique had higher ischemic complications rate than had the other two stenting procedures (P=0.023). Serum glucose (OR=1.48, P =0.014) and systolic blood pressure on admission (OR=0.97, P =0.046) were independent predictors of hemorrhagic complications during SAC. However, different stenting procedures and stent types were correlated neither aneurysm occlusion at the end of procedure ((P=0.498 and 0.176, respectively) nor favorable outcome at discharge (P=0.710 and 0.928, respectively).
Different stenting procedures were associated with thromboembolic but not hemorrhagic complications in SAC of ruptured wide-necked aneurysms.