Procedural Outcome Following Stent-Assisted Coiling for Wide-Necked Aneurysms Using Three Different Stent Models: A Single-Center Experience
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Procedural Outcome Following Stent-Assisted Coiling for Wide-Necked Aneurysms Using Three Different Stent Models: A Single-Center Experience. / Strittmatter, Catherine; Meyer, Lukas; Broocks, Gabriel; Alexandrou, Maria; Politi, Maria; Boutchakova, Maria; Henssler, Andreas; Reinges, Marcus; Simgen, Andreas; Papanagiotou, Panagiotis; Roth, Christian.
In: J CLIN MED, Vol. 11, No. 12, 3469, 16.06.2022.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Procedural Outcome Following Stent-Assisted Coiling for Wide-Necked Aneurysms Using Three Different Stent Models: A Single-Center Experience
AU - Strittmatter, Catherine
AU - Meyer, Lukas
AU - Broocks, Gabriel
AU - Alexandrou, Maria
AU - Politi, Maria
AU - Boutchakova, Maria
AU - Henssler, Andreas
AU - Reinges, Marcus
AU - Simgen, Andreas
AU - Papanagiotou, Panagiotis
AU - Roth, Christian
PY - 2022/6/16
Y1 - 2022/6/16
N2 - Previous case series have described the safety and efficacy of different stent models for stent-assisted aneurysm coiling (SAC), but comparative analyses of procedural results are limited. This study investigates the procedural outcome and safety of three different stent models (Atlas™, LEO+™ (Baby) and Enterprise™) in the setting of elective SAC treated at a tertiary neuro-endovascular center. We retrospectively reviewed all consecutively treated patients that received endovascular SAC for intracranial aneurysms between 1 July 2013 and 31 March 2020, excluding all emergency angiographies for acute subarachnoid hemorrhage. The primary procedural outcome was the occlusion rate evaluated with the Raymond-Roy occlusion classification (RROC) assessed on digital subtraction angiography (DSA) at 6- and 12-month follow-up. Safety assessment included periprocedural adverse events (i.e., symptomatic ischemic complications, symptomatic intracerebral hemorrhage, iatrogenic perforation, dissection, or aneurysm rupture and in-stent thrombosis) and in-house mortality. Uni- and multivariable logistic regression analyses were performed to identify patient baseline and aneurysm characteristics that were associated with complete aneurysm obliteration at follow-up. A total of 156 patients undergoing endovascular treatment via SAC met the inclusion criteria. The median age was 62 years (IQR, 55-71), and 73.7% (115) of patients were female. At first follow-up (6-month) and last available follow-up (12 and 18 months), complete aneurysm occlusion was observed in 78.3% (90) and 76.9% (102) of patients, respectively. There were no differences regarding the occlusion rates stratified by stent model. Multivariable logistic analysis revealed increasing dome/neck ratio (adjusted odds ratio (aOR), 0.26.; 95% CI, 0.11-0.64; p = 0.003), increasing neck size (aOR, 0.70; 95% CI, 0.51-0.96; p = 0.027), and female sex (aOR, 4.37; 95% CI, 1.68-11.36; p = 0.002) as independently associated with treatment success. This study showed comparable rates of complete long-term aneurysm obliteration and safety following SAC for intracranial aneurysm with three different stent-models highlighting the procedural feasibility of this treatment strategy with currently available stent-models. Increased neck size and a higher dome/neck ratio were independent variables associated with less frequent complete aneurysm obliteration.
AB - Previous case series have described the safety and efficacy of different stent models for stent-assisted aneurysm coiling (SAC), but comparative analyses of procedural results are limited. This study investigates the procedural outcome and safety of three different stent models (Atlas™, LEO+™ (Baby) and Enterprise™) in the setting of elective SAC treated at a tertiary neuro-endovascular center. We retrospectively reviewed all consecutively treated patients that received endovascular SAC for intracranial aneurysms between 1 July 2013 and 31 March 2020, excluding all emergency angiographies for acute subarachnoid hemorrhage. The primary procedural outcome was the occlusion rate evaluated with the Raymond-Roy occlusion classification (RROC) assessed on digital subtraction angiography (DSA) at 6- and 12-month follow-up. Safety assessment included periprocedural adverse events (i.e., symptomatic ischemic complications, symptomatic intracerebral hemorrhage, iatrogenic perforation, dissection, or aneurysm rupture and in-stent thrombosis) and in-house mortality. Uni- and multivariable logistic regression analyses were performed to identify patient baseline and aneurysm characteristics that were associated with complete aneurysm obliteration at follow-up. A total of 156 patients undergoing endovascular treatment via SAC met the inclusion criteria. The median age was 62 years (IQR, 55-71), and 73.7% (115) of patients were female. At first follow-up (6-month) and last available follow-up (12 and 18 months), complete aneurysm occlusion was observed in 78.3% (90) and 76.9% (102) of patients, respectively. There were no differences regarding the occlusion rates stratified by stent model. Multivariable logistic analysis revealed increasing dome/neck ratio (adjusted odds ratio (aOR), 0.26.; 95% CI, 0.11-0.64; p = 0.003), increasing neck size (aOR, 0.70; 95% CI, 0.51-0.96; p = 0.027), and female sex (aOR, 4.37; 95% CI, 1.68-11.36; p = 0.002) as independently associated with treatment success. This study showed comparable rates of complete long-term aneurysm obliteration and safety following SAC for intracranial aneurysm with three different stent-models highlighting the procedural feasibility of this treatment strategy with currently available stent-models. Increased neck size and a higher dome/neck ratio were independent variables associated with less frequent complete aneurysm obliteration.
U2 - 10.3390/jcm11123469
DO - 10.3390/jcm11123469
M3 - SCORING: Journal article
C2 - 35743537
VL - 11
JO - J CLIN MED
JF - J CLIN MED
SN - 2077-0383
IS - 12
M1 - 3469
ER -