Follow-up outcomes of intracranial aneurysms treated using braided or laser-cut stents with closed-cell design: a propensity score-matched case-controlled comparison

Lim, Jeongwook; Cho, Young Dae; Hong, Noah; Lee, Jeongjun; Yoo, Dong Hyun; Kang, Hyun Seung

doi:10.1136/neurintsurg-2020-016165

Cited by 11 publications

(13 citation statements)

References 29 publications

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“…In another study, the rate of aneurysm recanalization was lower in patients using braided stents than in those using laser-cut closed design stents. 35 In the present study, the initial (70%) and follow-up (71.4%) RR1 occlusion rates were acceptable, considering the findings of previous studies. At follow-up, recanalization was observed in three patients (14.3%; two with basilar top aneurysm and one with middle cerebral artery aneurysm).…”

Section: Discussionsupporting

confidence: 77%

Y-stent assisted coiling of ruptured wide neck intracranial aneurysm in the acute phase

et al. 2021

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Background The objective of the present study is to analyze the outcomes of patients with subarachnoid hemorrhage (SAH) in the acute phase after treatment with Y-stent-assisted coiling (YSAC) embolization. Methods This retrospective study assessed of 30 patients with acutely ruptured wide-neck aneurysms following YSAC treatment between April 2013 and October 2019. The demographic data, aneurysm occlusion grade, procedural and periprocedural complications, and clinical outcomes were assessed. Results The procedure was completed in 30 cases (90.1%) and technical failure occurred in 3 cases (9.1%). Immediate control angiography revealed that total occlusion Raymond-Ray Class 1 (RR1) was achieved in 21 (70%), neck filling (RR2) in eight (26.6%) and sac filling (RR1) in one (3.3%) aneurysm. Upon angiographic follow-up, RR1 occlusion was observed in 15 (71.4%) patients, RR2 in three (14.3%) patients and RR3 in three (14.3%) patients. In-stent thrombus developed in five (16.6%) patients; procedural ischemic events were observed in four (13.3%) patients; and two (6.6%) patients were symptomatic. A periprocedural asymptomatic intracranial hemorrhage was detected in two patients. At discharge, 17 (56.6%) patients were in good clinical condition, six (20%) were in a severe disability condition, and seven (23.3%) patients had died. At the final follow-up visit (mean: 18.9 months), 16 (76,2%) of 21 patients were in a good clinical condition and five (23.8%) had severe disabilities. Conclusions Y-stent assisted coiling in might be a feasible and promising option for treatment in acute phase in selected wide-necked ruptured intracranial aneurysms.

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Section: Discussionsupporting

confidence: 77%

Y-stent assisted coiling of ruptured wide neck intracranial aneurysm in the acute phase

et al. 2021

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“…Nevertheless, a recent systematic review showed that the follow-up complete occlusion and recurrence in the LVIS group were comparable with the laser-cut group ( P = 0.454, 0.056, respectively) ( 26 ). Lim et al ( 35 ) reported a cohort study and demonstrated similar outcomes in follow-up and recurrence rates between the LVIS group and the Enterprise group. Our cohort study showed that for ruptured tiny intracranial aneurysms, patients treated with LVIS yielded significantly higher follow-up complete occlusion and lower recurrence rates ( P = 0.014), while the retreatment rate was lower without statistical significance ( P = 0.27).…”

Section: Discussionmentioning

confidence: 79%

Stent-assisted coiling vs. coiling alone of ruptured tiny intracranial aneurysms: A contemporary cohort study in a high-volume center

Zhang

Wei

et al. 2022

Front. Neurol.

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ObjectiveThis study aims to compare the safety and efficacy of stent-assisted coiling (SAC) with those of coiling alone (CA) for the treatment of ruptured tiny intracranial aneurysms.MethodsWe enrolled 245 patients with ruptured tiny intracranial aneurysms treated with coil embolization. Patients were grouped into SAC and CA groups. Baseline characteristics, periprocedural complications, clinical outcomes, and angiographic results were compared between the two groups. In addition, a subgroup analysis was conducted in the SAC group, and patients were regrouped into low-profile visualized intraluminal support (LVIS) and laser-cut groups to compare the perioperative procedure-related complications and clinical and angiographic follow-up outcomes.ResultsAll baseline characteristics were equivalent between the two groups except for aneurysm size and dome-to-neck aspect ratio. The rates of overall procedure-related complications, intraprocedural rupture, postoperative early rebleeding, intraprocedural thrombosis, postprocedural thrombosis, and procedure-related mortality were comparable between the two groups (P = 0.105, 0.145, 0.308, 1.000, 1.000, 0.160, respectively). Nevertheless, the rate of hemorrhagic complication in the SAC group was significantly higher (P = 0.023). The angiographic follow-up outcomes showed that the SAC group had a higher complete occlusion rate and lower recurrence rate (88.2 vs. 67.1%, 5.4 vs. 15.2%, P = 0.001). The clinical outcomes at discharge and follow-up between the two groups demonstrated no significant differences (P = 0.192 and P = 0.085, respectively). For subgroup analysis, LVIS stents were associated with a significantly higher rate of complete occlusion (P = 0.014) and a lower rate of intraprocedural rupture (p = 0.021). Moreover, multivariate analysis showed that there were no predictors for the overall, hemorrhagic, and ischemic procedure-related complications, while Raymond class was an independent predictor of retreatment (OR = 3.508, 95% CI 1.168–11.603; P = 0.029).ConclusionStent-assisted coiling may increase the incidence of hemorrhagic events with favorable angiographic results and comparable clinical outcomes compared with stand-alone coiling. Nevertheless, LVIS stent could improve the safety compared with lazer-cut stent. Simultaneously, considering the better long-term effect, LVIS stent-assisted coiling may be a preferable choice for ruptured tiny intracranial aneurysms.

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“…Ge et al reported a higher rate of recanalization associated with enterprise stent than with the LVIS stent (10.7 vs 2.8%) ( 25 ). Lim et al observed in SAC of IAs, laser- cut and braided stent groups produced similar outcomes in follow-up, the difference of recanalization incidence rates between the braided- stent and the laser-cut group was not statistically significant ( 5 ).…”

Section: Discussionmentioning

confidence: 88%

“…Self-expanding braided stents have greater metal surface coverage and provide greater flow diversion to promote aneurysmal occlusion; examples include LVIS (Microvention, Aliso Viejo, CA, USA), LVIS Jr (Microvention), and LEO Baby (Balt, Montmorency, France). Both stent types are widely used in IA management and type superiority has not been established ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical and Angiographic Outcomes After Stent-Assisted Coiling of Cerebral Aneurysms With Laser-Cut and Braided Stents: A Comparative Analysis of the Literatures

et al. 2021

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Introduction: Stent-assisted coiling (SAC) plays an important role in endovascular treatment of intracranial aneurysms (IAs). This comparative analysis examines the safety and efficacy of SAC in general and compares clinical and angiographic outcomes between laser-cut stents and braided stents.Methods: Relevant English-language studies were identified via a PubMed search for published articles regarding outcomes of SAC using laser-cut stents and braided stents published from 2015 to 2020. Data from 56 studies that met our inclusion criteria were pooled and statistically compared.Results: A total of 4,373 patients harboring with 4,540 IAs were included. Patients were divided into two groups on the basis of stent type: laser-cut stents (2,076 aneurysms in 1991 patients; mean follow-up, 12.99 months) and braided stents (2,464 aneurysms in 2382 patients; mean follow-up, 18.41 months). Overall, the rates of successful stent deployment, thromboembolic events, stent stenosis, periprocedural intracranial hemorrhage, permanent morbidity, mortality, and recanalization were 97.72, 4.72, 2.87, 1.51, 2.14, 1.16, and 6.06%, respectively. Laser-cut stents were associated with a significantly higher rate of successful deployment (p = 0.003) and significantly lower rate of periprocedural intracranial hemorrhage (p = 0.048). Braided stents were associated with a significantly lower rate of permanent morbidity (p = 0.015).Conclusion: SAC of IAs using laser-cut stents or braided stents was effective and safe. Rates of thromboembolic events, stent stenosis, mortality, and recanalization were comparable between the stent types. Braided stents were associated with lower permanent morbidity while laser-cut stents were associated with more favorable rates of successful deployment and periprocedural intracranial hemorrhage.

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Follow-up outcomes of intracranial aneurysms treated using braided or laser-cut stents with closed-cell design: a propensity score-matched case-controlled comparison

Cited by 11 publications

References 29 publications

Y-stent assisted coiling of ruptured wide neck intracranial aneurysm in the acute phase

Y-stent assisted coiling of ruptured wide neck intracranial aneurysm in the acute phase

Stent-assisted coiling vs. coiling alone of ruptured tiny intracranial aneurysms: A contemporary cohort study in a high-volume center

Clinical and Angiographic Outcomes After Stent-Assisted Coiling of Cerebral Aneurysms With Laser-Cut and Braided Stents: A Comparative Analysis of the Literatures

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