Original scientific paper
https://doi.org/10.3325/cmj.2015.56.24
Long-term angiographic outcome of stent-assisted coiling compared to nonassisted coiling of intracranial saccular aneurysms
David Ozretić
; Department of Diagnostic and Interventional Radiology, University Hospital Center Zagreb, University of Zagreb School of Medicine,Zagreb, Croatia
Marko Radoš
; Department of Diagnostic and Interventional Radiology, University Hospital Center Zagreb, University of Zagreb School of Medicine,Zagreb, Croatia
Goran Pavliša
; Department of Diagnostic and Interventional Radiology, University Hospital Center Zagreb, University of Zagreb School of Medicine,Zagreb, Croatia
Zdravka Poljaković
; Department of Neurology, University Hospital Center Zagreb,University of Zagreb School ofMedicine, Zagreb, Croatia
Abstract
Aim To compare angiographic result at long-term followup,
and rates of progressive occlusion, recurrence, and retreatment
of stent-assisted coiled (SAC) and non-assisted
coiled (NAC) intracranial saccular aneurysms.
Methods Retrospective evaluation of department records
identified 260 patients with 283 saccular intracranial aneurysms
who had long-term angiographic follow-up (more
than 12 months) and were successfully treated with SAC
(89 aneurysms) or NAC (194 aneurysms) at the University
Hospital Center Zagreb from June 2005 to July 2012. Initial
and control angiographic results in both groups were
graded using Roy/Raymond scale, converted to descriptive
terms, and the differences between them were evaluated
for statistical significance. A multivariate analysis was
performed to identify factors related to progression of aneurysm
occlusion and recurrence at follow-up, and those
related to aneurysm retreatment.
Results There were more progressively occluded aneurysms
in SAC group (38 of 89 aneurysms, 42.7%) than in
NAC group (46 of 194, 23.7%) (P = 0.002), but there were
no significant differences in the rates of recanalization, regrowth,
and stable result. Multivariate logistic regression
identified the use of stent as the most important factor associated
with progressive occlusion (P = 0.015, odds ratio
2.22, 95% confidence interval 1.17-4.21), and large aneurysm
size and posterior circulation location as most predictive
of aneurysm recurrence and retreatment.
Conclusion The use of stent is associated with delayed occlusion
of initially incompletely coiled aneurysms during
follow-up, but does not reduce the rate of recurrence and
retreatment compared to coiling alone. Long-term angiographic
follow-up is needed for both SAC and NAC aneurysms.
Keywords
Hrčak ID:
139293
URI
Publication date:
15.2.2015.
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