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Neuroradiology
Published in: Neuroradiology 7/2018

01-07-2018 | Interventional Neuroradiology

Does stent type impact coil embolization outcomes in extended follow-up of small-sized aneurysms (< 10 mm)?

Authors: Jeongjun Lee, Young Dae Cho, Dong Hyun Yoo, Hyun-Seung Kang, Won-Sang Cho, Jeong Eun Kim, Jusun Moon, Moon Hee Han

Published in: Neuroradiology | Issue 7/2018

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Abstract

Purpose

Self-expandable stents have enabled endovascular treatment of wide-necked aneurysms (ordinarily viewed as technically prohibitive), with favorable outcomes. However, the impact of stent type on occlusive stability has not been adequately investigated. In small-sized unruptured saccular aneurysms, we generated estimates of stent-assisted coil embolization outcomes during follow-up monitoring. Stent type and other risk factors linked to recanalization were analyzed.

Methods

A cohort of 286 patients harboring 312 small-sized unruptured aneurysms (< 10 mm) was subjected to mid-term and extended follow-up monitoring after stent-assisted coiling. Three types of stents (Enterprise, 192; Neuroform, 27; LVIS, 93) were deployed in this population; all medical records and radiologic data of which were reviewed. Mid-term recanalization rates and related risk factors were assessed using binary logistic regression analysis.

Results

A total of 49 aneurysms (15.7%) displayed recanalization at 6 months postembolization, with 34 and 15 instances of minor and major recanalization, respectively. Multivariate analysis indicated that wide-necked aneurysms (> 4 mm) (HR = 2.362; p = 0.017), incomplete occlusion at time of coiling (HR = 2.949; p = 0.002), and stent type (p = 0.048) were significant factors in mid-term recanalization, whereas hypertension (p = 0.095) and packing density ≤ 30% (p = 0.213) fell short of statistical significance. Compared with Enterprise (HR = 2.828) or Neuroform (HR = 4.206) stents, outcomes proved more favorable with use of LVIS.

Conclusions

Above findings demonstrate that in addition to occlusive status at time of coil embolization and neck size, stent type may affect follow-up outcomes of stent-assisted coil embolization in small-sized aneurysms. LVIS (vs Enterprise or Neuroform stents) performed best during follow-up monitoring in terms of limiting recanalization.
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Metadata
Title
Does stent type impact coil embolization outcomes in extended follow-up of small-sized aneurysms (< 10 mm)?
Authors
Jeongjun Lee
Young Dae Cho
Dong Hyun Yoo
Hyun-Seung Kang
Won-Sang Cho
Jeong Eun Kim
Jusun Moon
Moon Hee Han
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 7/2018
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-018-2022-4

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