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. 2020 Jun 4;15(6):e0233981.
doi: 10.1371/journal.pone.0233981. eCollection 2020.

Intra-aneurysmal pressure changes during stent-assisted coiling

Piotr Piasecki  1 , Piotr Ziecina  1 , Krzysztof Brzozowski  1 , Marek Wierzbicki  1 , Jerzy Narloch  1
Affiliations

Intra-aneurysmal pressure changes during stent-assisted coiling

Piotr Piasecki et al. PLoS One. .

Abstract

We aimed to examine aneurysm hemodynamics with intra-saccular pressure measurement, and compare the effects of coiling, stenting and stent-assisted coiling in proximal segments of intracranial circulation. A cohort of 45 patients underwent elective endovascular coil embolization (with or without stent) for intracranial aneurysm at our department. Arterial pressure transducer was used for all measurements. It was attached to proximal end of the microcatheter. Measurements were taken in the parent artery before and after embolization, at the aneurysm dome before embolization, after stent implantation, and after embolization. Stent-assisted coiling was performed with 4 different stents: LVIS and LVIS Jr (Microvention, Tustin, CA, USA), Leo (Balt, Montmorency, France), Barrel VRD (Medtronic/ Covidien, Irvine, CA, USA). Presence of the stent showed significant reverse correlation with intra-aneurysmal pressure-both systolic and diastolic-after its implantation (r = -0.70 and r = -0.75, respectively), which was further supported by correlations with stent cell size-r = 0.72 and r = 0.71, respectively (P<0.05). Stent implantation resulted in significant decrease in diastolic intra-aneurysmal pressure (p = 0.046). Systolic or mean intra-aneurysmal pressure did not differ significantly. Embolization did not significantly change the intra-aneurysmal pressure in matched pairs, regardless of the use of stent (p>0.05). In conclusion, low-profile braided stents show a potential to divert blood flow, there was significant decrease in diastolic pressure after stent placement. Flow-diverting properties were related to stent porosity. Coiling does not significantly change the intra-aneurysmal pressure, regardless of packing density.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Schematic morphological measurements on 3D angiography.
Please refer to caption for Table 2. Dist. 1 –diameter of afferent parent artery; Dist. 2 –diameter of efferent parent artery; Dist. 4 –width of the sac; Dist. 6 –length of the sac (Dmax); Dist. 10 –height of the sac; Ang. 13 –delta angle.
Fig 2
Fig 2. Number of devices used for stent-assisted coiling.
Fig 3
Fig 3. Differences in coil use between stent-assisted and not assisted embolization.
Fig 4
Fig 4. Differences in systolic and diastolic intra-aneurysmal pressure between stent-assisted and not assisted embolization.
See this image and copyright information in PMC

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