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Predictors of unfavorable outcome in stent-assisted coiling for symptomatic unruptured intracranial spontaneous vertebral artery dissecting aneurysms (uis-VADAs): results from a multicenter study.
Zhao, Kaijun; Zhao, Rui; Yang, Xinjian; Guan, Sheng; Liang, Guobiao; Wang, Hong-Lei; Wang, Donghai; Feng, Wenfeng; Li, Zhenbao; Wang, Weiwei; Peng, Ya; Xu, Jing; Wang, Lei; Zhong, Ming; Mao, Guohua; Li, Tianxiao; Zhang, Yang; Chen, Dong; Cai, Chuwei; Sun, Xiaochuan; Shi, Huaizhang; Yu, Jianjun; Wang, Yang; Gu, Zhen; Zhu, Gang; Zhu, Qing; Wan, Jieqing; Li, Qiuping; Yang, Hua; Li, Gang; Chai, Erqing; Li, Qiang; Yang, Pengfei; Fang, Yibin; Dai, Dongwei; Hong, Bo; Huang, Qinghai; Xu, Yi; Liu, Jianmin; Xu, Jinyu.
Affiliation
  • Zhao K; Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China.
  • Zhao R; Department of Neurosurgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
  • Yang X; Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China.
  • Guan S; Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing, China chstroke@163.com yangxinjian@voiceoftiantan.org.
  • Liang G; Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China.
  • Wang HL; Department of Interventional Neuroradiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China.
  • Wang D; Department of Neurosurgery, General Hospital of Shenyang Military Command, Shenyang, Liaoning, China.
  • Feng W; Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, China.
  • Li Z; Department of Neurosurgery, Shandong University Qilu Hospital, Jinan, Shandong, China.
  • Wang W; Department of Neurosurgery, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China.
  • Peng Y; Department of Neurosurgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China.
  • Xu J; Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
  • Wang L; Cerebral Vascular Disease Center, Changzhou First People's Hospital, Changzhou, Jiangsu, China.
  • Zhong M; Cerebral Vascular Disease Center, Changzhou First People's Hospital, Changzhou, Jiangsu, China.
  • Mao G; Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China.
  • Li T; Department of Neurosurgery, Yichang Central People's Hospital, Yichang, Hubei, China.
  • Zhang Y; Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
  • Chen D; Department of Neurosurgery, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China.
  • Cai C; Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
  • Sun X; Department of Neurosurgery, Anhui Provincial Hospital, Hefei, Anhui, China.
  • Shi H; Department of Neurosurgery, Shenzhen People's Hospital, Shenzhen, Guangdong, China.
  • Yu J; Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
  • Wang Y; Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Sichuan, China.
  • Gu Z; Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
  • Zhu G; Department of Cerebrovascular Disease, Linyi People's Hospital, Linyi, Shandong, China.
  • Zhu Q; Department of Interventional Neuroradiology, Beijing Chaoyang Hospital, Beijing, China.
  • Wan J; Department of Neurosurgery, Kunming Medical College Fourth Affiliated Hospital, Kunming, Yunnan, China.
  • Li Q; Department of Neurosurgery, Third Military Medical University Southwest Hospital, Chongqing, China.
  • Yang H; Department of Neurosurgery, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
  • Li G; Department of Neurosurgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China.
  • Chai E; Department of Neurosurgery, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China.
  • Li Q; Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China.
  • Yang P; Department of Cerebrovascular Disease, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China.
  • Fang Y; Department of Neurosurgery, Gansu Provincial Hospital, Lanzhou, Gansu, China.
  • Dai D; Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China.
  • Hong B; Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China.
  • Huang Q; Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China.
  • Xu Y; Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China.
  • Liu J; Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China.
  • Xu J; Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China.
J Neurointerv Surg ; 14(10): 1008-1013, 2022 Oct.
Article in En | MEDLINE | ID: mdl-34753811
ABSTRACT

OBJECTIVE:

To evaluate predictors of unfavorable outcome in stent-assisted coiling for symptomatic unruptured intracranial spontaneous vertebral artery dissecting aneurysms (uis-VADAs) based on 608 reconstructed lesions in 30 medical centres.

METHODS:

A total of 608 patients (malefemale=479129; mean age, 53.26±10.26 years) with 608 symptomatic uis-VADAs underwent reconstructive treatments using stent(s) with coils between January 2009 and December 2015. Treatments and predictors of unfavorable outcomes were retrospectively analyzed.

RESULTS:

Mainly, three methods were used to treat patients with uis-VADAs, including routine single-stent in 208 patients (such as Enterprise and others), new low-profile LVIS single stent in 107 patients, and multiple stents in 293 patients. During the median 66 months of clinical follow-up, 14 patients died, and 16 of the remaining 594 survivors had unfavorable outcomes (modified Rankin Scale score 3-5). The overall mortality rate was 2.3% (14/608), and the unfavorable outcome (mRS score 3-6) rate was 4.9% (30/608). Multivariate logistic regression analysis indicated that preprocedural ischemic infarctions (OR=3.78; 95% CI 1.52 to 9.40; p<0.01), diabetes mellitus (OR=3.74; 95% CI 1.31 to 10.68; p=0.01), and procedural complications (OR=14.18; 95% CI 5.47 to 36.80; p<0.01) were predictors of unfavorable outcome in the reconstructed VADAs.

CONCLUSIONS:

This multicenter study indicated that preprocedural ischemic infarctions, diabetes mellitus, and procedural complications were related to unfavorable clinical outcomes in the reconstructed uis-VADAs.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Intracranial Aneurysm / Vertebral Artery Dissection / Embolization, Therapeutic Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: J Neurointerv Surg Year: 2022 Document type: Article
Fulltext
Print
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PubMed Links
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Intracranial Aneurysm / Vertebral Artery Dissection / Embolization, Therapeutic Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: J Neurointerv Surg Year: 2022 Document type: Article