The First Affiliated Hospital of Chengdu Medical College, Department of Neurosurgery, Chengdu, Sichuan, China.
The First Affiliated Hospital of Chengdu Medical College, Department of Hematology, Chengdu, Sichuan, China.
Clinics (Sao Paulo). 2023 Apr 30;78:100202. doi: 10.1016/j.clinsp.2023.100202. eCollection 2023.
Braided and laser-cut stents both are efficacious and safe for coiling intracranial aneurysms. The study aimed to compare outcomes following braided stent-assisted coil embolization versus laser engraved stent-assisted coil embolization in 266 patients who were diagnosed with unruptured intracranial aneurysms of different types and locations.
Patients with unruptured complex intracranial aneurysms underwent braided (BSE cohort, n = 125) or laser engraved (LSE cohort, n = 141) stent-assisted embolization.
The deployment success rate was higher for patients of the LSE cohort than those of the BSE cohort (140 [99%] vs. 117 [94%], p = 0.0142). Seventy-one (fifty-seven percentages) and 73 (52%) were coil embolization procedure success rates of the BSE and the LSE cohorts. Periprocedural intracranial hemorrhage was higher in patients of the BSE cohort than those of the LSE cohort (8 [6%] vs. 1 [1%], p = 0.0142). Four (three percentages) patients from the LSE cohort and 3 (2%) patients from the BSE cohort had in-stent thrombosis during embolization. Permanent morbidities were higher in patients of the LSE cohort than those of the BSE cohort (8 [6%] vs. 1 [1%], p = 0.0389). Higher successful procedures (76% vs. 68%) and fewer postprocedural intracranial hemorrhage (0% vs. 5%) and mortality (0% vs. 5%) were reported for patients of the BSE cohort in posterior circulation aneurysmal location than those of the LSE cohort. Laser engraved stent has fewer problems with deployment and may have better periprocedural and follow-up outcomes after embolization.
Braided stent-assisted embolization should be preferred when the aneurysm is present in the posterior circulation.
编织支架和激光切割支架在颅内动脉瘤的线圈栓塞中均有效且安全。本研究旨在比较 266 例不同类型和部位未破裂颅内动脉瘤患者采用编织支架辅助线圈栓塞（BSE 组，n=125）与激光雕刻支架辅助线圈栓塞（LSE 组，n=141）的结果。
对未破裂复杂颅内动脉瘤患者行编织支架（BSE 组，n=125）或激光雕刻支架（LSE 组，n=141）辅助栓塞。
LSE 组的支架释放成功率高于 BSE 组（140[99%]比 117[94%]，p=0.0142）。BSE 组和 LSE 组的线圈栓塞成功率分别为 71 例（57%）和 73 例（52%）。BSE 组患者围手术期颅内出血发生率高于 LSE 组（8[6%]比 1[1%]，p=0.0142）。LSE 组 4 例（3%）患者和 BSE 组 3 例（2%）患者在栓塞过程中出现支架内血栓形成。LSE 组永久性并发症发生率高于 BSE 组（8[6%]比 1[1%]，p=0.0389）。BSE 组后循环动脉瘤位置患者的手术成功率较高（76%比 68%），术后颅内出血发生率较低（0%比 5%）和死亡率较低（0%比 5%）。
对于后循环中的动脉瘤，应优先选择编织支架辅助栓塞。
