Safety and Efficacy of Stent-Assisted Coiling of Unruptured Intracranial Aneurysms Using Low-Profile Stents in Small Parent Arteries

被引:15
作者
Kim, J. [1 ]
Han, H. J. [1 ]
Lee, W. [2 ]
Park, S. K. [2 ]
Chung, J. [1 ]
Kim, Y. B. [1 ]
Park, K. Y. [1 ]
机构
[1] Yonsei Univ, Gangnam Severance Hosp, Coll Med, Dept Neurosurg,Severance Stroke Ctr, Seoul, South Korea
[2] Yonsei Univ, Gangnam Severance Hosp, Coll Med, Dept Neurosurg, 50 Yonsei Ro, Seoul 03722, South Korea
关键词
ENDOVASCULAR TREATMENT; LVIS JR; EMBOLIZATION; SMOKING;
D O I
10.3174/ajnr.A7196
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND AND PURPOSE: Stent-assisted coiling of intracranial aneurysms arising from small vessels (<= 2.0mm) is a common procedure. However, data regarding its treatment outcomes are scarce. This study evaluated the clinical and radiologic outcomes of stent-assisted coiling using low-profile stents for aneurysms of small parent arteries. MATERIALS AND METHODS: From November 2015 to October 2020, sixty-four patients with 66 aneurysms arising from parent arteries of <= 2.0mm were treated with stent-assisted coiling using a Low-Profile Visualized Intraluminal Support Junior (LVIS Jr) or the Neuroform Atlas stent in a single institution. The clinical and radiologic data were retrospectively reviewed, and the risk factors for procedure-related complications were evaluated. RESULTS: The LVIS Jr and Neuroform Atlas stents were used in 22 (33.3%) and 44 (66.7%) cases, respectively. Technical success was achieved in 66 cases (100%). Immediate postprocedural aneurysm occlusion grades assessed by the Raymond-Roy occlusion classification were I (57.6%), II (19.7%), and III (22.7%), respectively. Procedure-related complications occurred in 10 cases (15.2%), with 8 thromboembolic complications (12.1%) and 2 hemorrhagic complications (3.0%). Procedure-related morbidity was 4.5% without mortality. On multivariate analysis, current smoking (odds ratio = 7.1, P = .021) had a statistically significant effect on procedure-related complications. CONCLUSIONS: Stent-assisted coiling of intracranial aneurysms with low-profile stents in small vessels (<= 2.0 mm) had a 100% success rate and a 15.2% overall complication rate with 4.5% morbidity. Current smoking was a significant risk factor associated with procedure-related complications.
引用
收藏
页码:1621 / 1626
页数:6
相关论文
共 32 条
[1]   Ischemic Stroke After Treatment of Intraprocedural Thrombosis During Stent-Assisted Coiling and Flow Diversion [J].
Adeeb, Nimer ;
Griessenauer, Christoph J. ;
Moore, Justin M. ;
Foreman, Paul M. ;
Shallwani, Hussain ;
Motiei-Langroudi, Rouzbeh ;
Gupta, Raghav ;
Baccin, Carlos E. ;
Alturki, Abdulrahman ;
Harrigan, Mark R. ;
Siddiqui, Adnan H. ;
Levy, Elad I. ;
Ogilvy, Christopher S. ;
Thomas, Ajith J. .
STROKE, 2017, 48 (04) :1098-1100
[2]  
Akpek S, 2005, AM J NEURORADIOL, V26, P1223
[3]   Stent-assisted coiling of intracranial aneurysms located on small vessels: midterm results with the LVIS Junior stent in 40 patients with 43 aneurysms [J].
Alghamdi, Faisal ;
Mine, Benjamin ;
Morais, Ricardo ;
Scillia, Pietro ;
Lubicz, Boris .
NEURORADIOLOGY, 2016, 58 (07) :665-671
[4]   Stent-Assisted Coiling of Wide-Neck Intracranial Aneurysms Using Low-Profile LEO Baby Stents: Initial and Midterm Results [J].
Aydin, K. ;
Arat, A. ;
Sencer, S. ;
Barburoglu, M. ;
Men, S. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2015, 36 (10) :1934-1941
[5]   Multicenter Postmarket Analysis of the Neuroform Atlas Stent for Stent-Assisted Coil Embolization of Intracranial Aneurysms [J].
Burkhardt, J. -K. ;
Srinivasan, V. ;
Srivatsan, A. ;
Albuquerque, F. ;
Ducruet, A. F. ;
Hendricks, B. ;
Gross, B. A. ;
Jankowitz, B. T. ;
Thomas, A. J. ;
Ogilvy, C. S. ;
Maragkos, G. A. ;
Enriquez-Marulanda, A. ;
Crowley, R. W. ;
Levitt, M. R. ;
Kim, L. J. ;
Griessenauer, C. J. ;
Schirmer, C. M. ;
Dalal, S. ;
Piper, K. ;
Mokin, M. ;
Winkler, E. A. ;
Abla, A. A. ;
McDougall, C. ;
Birnbaum, L. ;
Mascitelli, J. ;
Litao, M. ;
Tanweer, O. ;
Riina, H. ;
Johnson, J. ;
Chen, S. ;
Kan, P. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2020, 41 (06) :1037-1042
[6]   Low-Dose Prasugrel vs Clopidogrel-Based Tailored Premedication for Endovascular Treatment of Cerebral Aneurysms [J].
Cho, Won-Sang ;
Lee, Joongyub ;
Ha, Eun Jin ;
Kim, Kyung Hyun ;
Lee, Jeongjun ;
Cho, Young Dae ;
Kim, Jeong Eun ;
Han, Moon Hee ;
Kang, Hyun-Seung .
NEUROSURGERY, 2019, 85 (01) :E52-E59
[7]   Preliminary experience with self-expanding closed-cell stent placement in small arteries less than 2 mm in diameter for the treatment of intracranial aneurysms [J].
Chung, Joonho ;
Suh, Sang Hyun ;
Hong, Chang-Ki ;
Joo, Jin-Yang ;
Lim, Yong Cheol ;
Shin, Yong Sam ;
Kim, Yong Bae .
JOURNAL OF NEUROSURGERY, 2015, 122 (06) :1503-1510
[8]   Atherosclerotic vascular disease conference - Writing group III: Pathophysiology [J].
Faxon, DP ;
Fuster, V ;
Libby, P ;
Beckman, JA ;
Hiatt, WR ;
Thompson, RW ;
Topper, JN ;
Annex, BH ;
Rundback, JH ;
Fabunmi, RP ;
Robertson, RM ;
Loscalzo, J .
CIRCULATION, 2004, 109 (21) :2617-2625
[9]   Treatment of wide-necked aneurysms with the Low-profile Visualized Intraluminal Support (LVIS Jr) device: a multicenter experience [J].
Grossberg, J. A. ;
Hanel, R. A. ;
Dabus, G. ;
Keigher, K. ;
Haussen, D. C. ;
Sauvageau, E. ;
Linfante, I. ;
Gonsales, D. ;
Salinas, P. Aguilar ;
Bouslama, M. ;
Mayich, M. ;
Nogueira, R. G. ;
Lopes, D. K. .
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2017, 9 (11) :1098-1102
[10]   Stent-Assisted Coiling versus Coiling in Treatment of Intracranial Aneurysm: A Systematic Review and MetaAnalysis [J].
Hong, Yuan ;
Wang, Yong-Jie ;
Deng, Zheng ;
Wu, Qun ;
Zhang, Jian-Min .
PLOS ONE, 2014, 9 (01)