Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2011 Oct;32(9):1707-10.
doi: 10.3174/ajnr.A2592. Epub 2011 Aug 18.

Comparison of 2-year angiographic outcomes of stent- and nonstent-assisted coil embolization in unruptured aneurysms with an unfavorable configuration for coiling

G Hwang  1 , H Park, J S Bang, S-C Jin, B C Kim, C W Oh, H S Kang, M H Han, O-K Kwon
Affiliations
Comparative Study

Comparison of 2-year angiographic outcomes of stent- and nonstent-assisted coil embolization in unruptured aneurysms with an unfavorable configuration for coiling

G Hwang et al. AJNR Am J Neuroradiol. 2011 Oct.

Abstract

Background and purpose: Stents are known to have hemodynamic and biologic effects in addition to their mechanical scaffold effect. To determine whether stents affect long-term outcomes after coiling of unruptured aneurysms, we compared angiographic outcomes at 2 years postembolization for stent- and nonstent-assisted coiled unruptured aneurysms.

Materials and methods: Stent-assisted coiling was used in unruptured aneurysms unfavorable for simple coiling (neck size >4 mm and dome-to-neck ratio <1.5) in our practice. Therefore, 126 coiled unruptured aneurysms in total (40 [31.7%] stent group and 86 [68.3%] nonstent group) with these conditions were selected for this study. The nonstent group aneurysms were treated with multiple microcatheter technique (53 cases) or balloon-assisted technique (33 cases). Self-expandable stents were used for coiling in stent group aneurysms. No significant difference in aneurysmal characteristics (aneurysm type [sidewall/bifurcation], diameter, neck size, and dome-to-neck ratio) or angiographic outcome at embolization (packing attenuation, obliteration grade, and contrast filling) were observed between the 2 study groups.

Results: At 2-year follow-up visits, rates of progressive occlusion (stent group, 17/40 [42.5%] versus nonstent group, 34/86 [39.5%]) and recanalization (7/40 [17.5%] versus 18/86 [21.0%]) did not show a statistically significant difference between the 2 groups (P = .895).

Conclusions: The present study did not show that additional hemodynamic and biologic effects of stents designed for neck remodeling were enough to enhance progressive occlusion and prevent the recanalization of unruptured aneurysms. Our finding suggests that stent placement provides no better long-term angiographic outcomes for unruptured aneurysms with an unfavorable configuration for coiling.

PubMed Disclaimer

Figures

Fig 1.
Fig 1.
Patient flow according to exclusion criteria for this study.
See this image and copyright information in PMC

Comment in

References

    1. Canton G, Levy DI, Lasheras JC. Hemodynamic changes due to stent placement in bifurcating intracranial aneurysms. J Neurosurg 2005; 103: 146–55 - PubMed
    1. Canton G, Levy DI, Lasheras JC, et al. . Flow changes caused by the sequential placement of stents across the neck of sidewall cerebral aneurysms. J Neurosurg 2005; 103: 891–902 - PubMed
    1. Kim M, Levy EI, Meng H, et al. . Quantification of hemodynamic changes induced by virtual placement of multiple stents across a wide-necked basilar trunk aneurysm. Neurosurgery 2007; 61: 1305–12; discussion 1312–03 - PMC - PubMed
    1. Lieber BB, Gounis MJ. The physics of endoluminal stenting in the treatment of cerebrovascular aneurysms. Neurol Res 2002; 24 Suppl 1: S33–42 - PubMed
    1. Lieber BB, Livescu V, Hopkins LN, et al. . Particle image velocimetry assessment of stent design influence on intra-aneurysmal flow. Ann Biomed Eng 2002; 30: 768–77 - PubMed

Publication types