Comparison of Stent-Assisted Coiling and Balloon-Assisted Coiling in the Treatment of Ruptured Wide-Necked Intracranial Aneurysms in the Acute Period.
World Neurosurg
; 96: 316-321, 2016 Dec.
Article
em En
| MEDLINE
| ID: mdl-27647035
ABSTRACT
OBJECTIVE:
The purpose of this study was to compare the efficacy, stability, and safety of stent-assisted coiling (SAC) and balloon-assisted coiling (BAC) in the treatment of ruptured wide-necked aneurysms in the acute period.METHODS:
Consecutive patients including 65 cases treated with SAC and 32 with BAC were reviewed at the authors' institution between November 2011 and December 2014. The efficacy of these 2 approaches and the incidence of periprocedural complications were retrospectively evaluated.RESULTS:
Morphologic analysis showed a lower fundus/neck ratio (1.2 vs. 1.6) in the aneurysms treated with SAC versus BAC (P < 0.001). The mean neck width of aneurysms was 4.0 mm in the patients treated with SAC versus 3.4 mm in those treated with BAC (P < 0.04). Coil protrusion into the parent vessels during embolization was an independent risk factor for cerebral ischemic events (odds ratio [OR], 4.08; 95% confidence interval [CI], 1.03-16.2). Neck width (OR, 0.65; 95% CI, 0.44-0.97) and aneurysm perforation during procedure (OR, 6.24; 95% CI, 1.21-32.3) were independent predictors of complete occlusion (Raymond 1) by immediate postembolization angiography. There was no statistical difference between the 2 techniques regarding the rate of aneurysm occlusion at the end of procedure, periprocedural complications, and favorable outcome at discharge and follow-up.CONCLUSIONS:
These findings suggested that SAC was more appropriate than BAC for ruptured wide-necked aneurysms with lower fundus/neck ratio or wider neck size. However, periprocedural complications, occlusion rates, and favorable outcomes did not differ between the 2 techniques.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Stents
/
Aneurisma Intracraniano
/
Aneurisma Roto
/
Embolização Terapêutica
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article