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Safety and efficacy of stent-assisted coiling for acutely ruptured wide-necked intracranial aneurysms: comparison of LVIS stents with laser-cut stents.

作者信息

Xue Gaici, Zuo Qiao, Zhang Xiaoxi, Tang Haishuang, Zhao Rui, Li Qiang, Fang Yibin, Yang Pengfei, Hong Bo, Xu Yi, Huang Qinghai, Liu Jianmin

机构信息

Department of Neurosurgery, General Hospital of Southern Theatre Command of PLA, 111 Liuhua Road, Guangzhou, 510010, China.

Department of Neurosurgery, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai, 200433, China.

出版信息

Chin Neurosurg J. 2021 Mar 3;7(1):19. doi: 10.1186/s41016-021-00237-1.


DOI:10.1186/s41016-021-00237-1
PMID:33653398
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7927374/
Abstract

BACKGROUND: To compare the safety and efficacy of LVIS stent-assisted coiling with those of laser-cut stent-assisted coiling for the treatment of acutely ruptured wide-necked intracranial aneurysms. METHODS: Patients with acutely ruptured wide-necked intracranial aneurysms treated with LVIS stent-assisted coiling (LVIS stent group) and laser-cut stent-assisted coiling (laser-cut stent group) were retrospectively reviewed from January 2014 to December 2017. Propensity score matching was used to adjust for potential differences in age, sex, aneurysm location, aneurysm size, neck width, Hunt-Hess grade, and modified Fisher grade. Perioperative procedure-related complications and clinical and angiographic follow-up outcomes were compared. Univariate and multivariate analyses were performed to determine the associations between procedure-related complications and potential risk factors. RESULTS: A total of 142 patients who underwent LVIS stent-assisted coiling and 93 patients who underwent laser-cut stent-assisted coiling were enrolled after 1:2 propensity score matching. The angiographic follow-up outcomes showed that the LVIS stent group had a slightly higher complete occlusion rate and lower recurrence rate than the laser-cut stent group (92.7% vs 80.6%; 3.7% vs 9.7%, P = 0.078). The clinical outcomes at discharge and follow-up between the two groups demonstrated no significant differences (P = 0.495 and P = 0.875, respectively). The rates of intraprocedural thrombosis, postprocedural thrombosis, postoperative early rebleeding, and procedure-related death were 0.7% (1/142), 1.4% (2/142), 2.8% (4/142), and 2.1% (3/142) in the LVIS stent group, respectively, and 4.3% (4/93), 2.2% (2/93), 1.1% (1/93), and 3.2% (3/93) in the laser-cut stent group, respectively (P = 0.082, 0.649, 0.651, and 0.683). Nevertheless, the rates of overall procedure-related complications and intraprocedural rupture in the LVIS stent group were significantly lower than those in the laser-cut stent group (5.6% vs 14.0%, P = 0.028; 0.7% vs 6.5%, P = 0.016). Multivariate analysis showed that laser-cut stent-assisted coiling was an independent predictor for overall procedure-related complications (OR = 2.727, P = 0.037); a history of diabetes (OR = 7.275, P = 0.027) and other cerebrovascular diseases (OR = 8.083, P = 0.022) were independent predictors for ischemic complications, whereas none of the factors were predictors for hemorrhagic complications. CONCLUSIONS: Compared with laser-cut stent-assisted coiling, LVIS stent-assisted coiling for the treatment of acutely ruptured wide-necked intracranial aneurysms could reduce the rates of overall procedure-related complications and intraprocedural rupture.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9af/7927374/250614fe15ea/41016_2021_237_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9af/7927374/250614fe15ea/41016_2021_237_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9af/7927374/250614fe15ea/41016_2021_237_Fig1_HTML.jpg

相似文献

[1]
Safety and efficacy of stent-assisted coiling for acutely ruptured wide-necked intracranial aneurysms: comparison of LVIS stents with laser-cut stents.

Chin Neurosurg J. 2021-3-3

[2]
Comparison of Low-Profiled Visualized Intraluminal Support Stent-Assisted Coiling and Coiling Only for Acutely Ruptured Intracranial Aneurysms: Safety and Efficacy Based on a Propensity Score-Matched Cohort Study.

Neurosurgery. 2020-9-1

[3]
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Front Neurol. 2022-12-6

[4]
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[5]
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Clin Neurol Neurosurg. 2022-7

[6]
Safety of coiling with stent placement for the treatment of ruptured wide-necked intracranial aneurysms: a contemporary cohort study in a high-volume center after improvement of skills and strategy.

J Neurosurg. 2018-8-17

[7]
[LVIS stent-assisted coil embolization in the acute stage of ruptured intracranial aneurysms].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2020-7

[8]
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[9]
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[10]
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引用本文的文献

[1]
Different antiplatelet regimens for stenting versus coiling for acutely-ruptured cerebral aneurysms.

Sci Rep. 2024-12-5

[2]
Single centre experience of stent-assisted coiling of wide-necked basilar tip aneurysms.

Br J Radiol. 2023-11

[3]
Stent-assisted coiling vs. coiling alone of ruptured tiny intracranial aneurysms: A contemporary cohort study in a high-volume center.

Front Neurol. 2022-12-6

本文引用的文献

[1]
Expanding the Indications for Flow Diversion: Treatment of Posterior Circulation Aneurysms.

Neurosurgery. 2020-1-1

[2]
Stent-assisted coiling of cerebral aneurysms: multi-center analysis of radiographic and clinical outcomes in 659 patients.

J Neurointerv Surg. 2019-9-17

[3]
Comparison of stent-assisted and no-stent coil embolization for safety and effectiveness in the treatment of ruptured intracranial aneurysms.

J Neurosurg. 2019-8-30

[4]
The Safety and Efficacy of Continuous Tirofiban as a Monoantiplatelet Therapy in the Management of Ruptured Aneurysms Treated Using Stent-Assisted Coiling or Flow Diversion and Requiring Ventricular Drainage.

Neurosurgery. 2019-12-1

[5]
Efficacy of LVIS vs. Enterprise Stent for Endovascular Treatment of Medium-Sized Intracranial Aneurysms: A Hemodynamic Comparison Study.

Front Neurol. 2019-5-28

[6]
Stent assisted coiling versus non-stent assisted coiling for the management of ruptured intracranial aneurysms: a meta-analysis and systematic review.

J Neurointerv Surg. 2019-3-6

[7]
Early Versus Delayed Flow Diversion for Ruptured Intracranial Aneurysms: A Meta-Analysis.

World Neurosurg. 2019-2-26

[8]
Endovascular treatment of middle cerebral artery aneurysm with a (LVIS) device: Comparison of LVIS stent and non-LVIS stent.

Exp Ther Med. 2019-3

[9]
Secondary hemorrhagic complications in aneurysmal subarachnoid hemorrhage: when the impact hits hard.

J Neurosurg. 2019-1-25

[10]
Intracranial Complex Ruptured Aneurysms Coiled with Overlapping Low-Profile Visualized Intraluminal Support Stents: Another Available Option for Complex Ruptured Intracranial Aneurysms.

World Neurosurg. 2019-5

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