Effect of stenting on progressive occlusion of small unruptured saccular intracranial aneurysms with residual sac immediately after coil embolization: a propensity score analysis

Jeon, Jin Pyeong; Cho, Young Dae; Rhim, Jong Kook; Park, Jeong Jin; Cho, Won Sang; Kang, Hyun-Seung; Kim, Jeong Eun; Han, Moon Hee

doi:10.1136/neurintsurg-2015-011947

Cited by 12 publications

(11 citation statements)

References 26 publications

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“…Currently, coil embolization is a safe and effective procedure for the treatment of ruptured intracranial aneurysms. [1][2][3] As endovascular therapy becomes more commonly used for treating aneurysms, the prevalence of periprocedural complications is expected to rise accordingly. 4 The main causes of morbidity and mortality are thromboembolisms, intraprocedural aneurysm ruptures, and postprocedural aneurysmal reruptures.…”

Section: Introductionmentioning

confidence: 99%

Acute rerupture after coil embolization of ruptured intracranial saccular aneurysms: A literature review

Guo

Zhao

et al. 2017

Interv Neuroradiol

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Acute rerupture after coil embolization is defined as rerupture within three days after treatment; its prognosis is worse than that of rebleeding at other time periods. However, to date, little is known about complications during the acute phase. Therefore, we used the PubMed database to perform a review of acute rerupture after coil embolization of ruptured intracranial saccular aneurysms and increase our understanding. After reviewing the complications, we found that the cause of acute rerupture is unclear, but the following risk factors are involved: incomplete occlusion of the initial aneurysm, the presence of a hematoma adjacent to a ruptured aneurysm, an aneurysmal outpouching, poor Hunt-Hess grade at the time of treatment, and the location of the aneurysm in an anterior communicating artery. In addition, intraoperative rupture is a non-negligible cause. Acute rerupture after coil embolization mainly occurs within the first 24 hours after the procedure. Brain computed tomography is the gold standard for diagnosing acute rebleeding of a coiled aneurysm. For acute rerupture after coil embolization, prevention is critical, and complete occlusion of the aneurysm in the first session is the best protection against acute rebleeding. In addition, a restricted postembolization anticoagulation strategy is recommended for patients with high-risk aneurysms. For patients with an adjacent hematoma, surgical clipping is recommended. Most patients present no changes immediately after acute rebleeding because of their poor condition. However, surgical or endovascular treatments can be attempted if the patient is in an acceptable condition. Even so, the outcomes are typically unsatisfactory.

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Section: Introductionmentioning

confidence: 99%

Acute rerupture after coil embolization of ruptured intracranial saccular aneurysms: A literature review

Guo

Zhao

et al. 2017

Interv Neuroradiol

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“…7) A study examined the results of coil embolization with respect to the presence or absence of stent use in patients in whom incomplete occlusion of cerebral aneurysms at the completion of coil embolization led to complete occlusion. 8) Although there was no significant difference between stentassisted and non-stent-assisted groups, the use of stents markedly increased the complete occlusion rate, excluding confounding factors, such as the aneurysmal size.…”

Section: Disclosure Statementmentioning

confidence: 84%

A Patient in Whom Straightening of a Parent Vessel Related to Insertion of a Braided Stent Contributed to Complete Occlusion of an Intracranial Aneurysm

Fujii

Oishi

Teranishi

et al. 2019

JNET

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We report a patient in whom vascular straightening was achieved after stent-assisted coil embolization, leading to complete occlusion of an intracranial aneurysm after 1 year. Case Presentation: The patient was a 60-year-old female. A medical checkup of the brain showed a posterior inferior cerebellar artery (PICA) aneurysm. Under general anesthesia, coil embolization was performed. During surgery, a coil deviated onto the PICA side, and a stent was deployed so that the aneurysmal neck might be located at its center. Finally, incomplete occlusion of the aneurysm was achieved. Cerebral angiography 1 year after surgery indicated a sharper branching angle of the blood vessel in comparison with the preoperative angle and complete occlusion of the aneurysm. Conclusion: A braided stent inserted to a site where a thin parent vessel is not fixed by the peripheral structure may make the parent vessel straight, contributing to complete occlusion of an aneurysm.

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“…Although, TOF MRA can be helpful in estimating the degree of recanalization, stent artifacts obscuring minor recanalization could occur. [27][28][29][30] Moreover, the mean aneurysm size in our subjects was estimated at 6.3 Ϯ 3.2 mm. In Korea, coiled aneurysms Յ10 mm account for 89.3% of lesions in a national cohort of unruptured aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Fate of Coiled Aneurysms with Minor Recanalization at 6 Months: Rate of Progression to Further Recanalization and Related Risk Factors

Jeon

Cho²,

Rhim³

et al. 2016

American Journal of Neuroradiology

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Effect of stenting on progressive occlusion of small unruptured saccular intracranial aneurysms with residual sac immediately after coil embolization: a propensity score analysis

Abstract: Small UIAs with residual sac filling after coiling showed a complete occlusion rate of 88.3% at 6 months post embolization. Stent deployment seems to promote complete occlusion in such lesions.

Cited by 12 publications

References 26 publications

Acute rerupture after coil embolization of ruptured intracranial saccular aneurysms: A literature review

Acute rerupture after coil embolization of ruptured intracranial saccular aneurysms: A literature review

A Patient in Whom Straightening of a Parent Vessel Related to Insertion of a Braided Stent Contributed to Complete Occlusion of an Intracranial Aneurysm

Fate of Coiled Aneurysms with Minor Recanalization at 6 Months: Rate of Progression to Further Recanalization and Related Risk Factors

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