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Influences of stents on the outcome of coil embolized intracranial aneurysms: comparison between a stent-remodeled and non-remodeled treatment

Authors
 Dong Joon Kim  ;  Sang Hyun Suh  ;  Jae Whan Lee  ;  Byung Moon Kim  ;  Jae Wook Lee  ;  Seung Kon Huh  ;  Dong Ik Kim 
Citation
 ACTA NEUROCHIRURGICA, Vol.152(3) : 423-429, 2010 
Journal Title
ACTA NEUROCHIRURGICA
ISSN
 0001-6268 
Issue Date
2010
MeSH
Aged ; Angiography, Digital Subtraction/methods ; Cerebral Arteries/diagnostic imaging ; Cerebral Arteries/pathology ; Cerebral Arteries/physiology ; Disease Progression ; Embolization, Therapeutic/instrumentation* ; Embolization, Therapeutic/methods* ; Female ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/pathology* ; Intracranial Aneurysm/therapy* ; Intracranial Thrombosis/diagnostic imaging ; Intracranial Thrombosis/epidemiology ; Intracranial Thrombosis/pathology ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/epidemiology ; Postoperative Complications/pathology ; Prostheses and Implants/standards ; Prostheses and Implants/statistics & numerical data ; Prosthesis Implantation/methods* ; Regeneration/physiology ; Severity of Illness Index ; Stents/standards ; Stents/statistics & numerical data* ; Treatment Outcome
Abstract
PURPOSE: The influences of a stent on the outcome of embolized aneurysms are not well known. The purpose of this study is to assess and compare the angiographic follow-up (FU) results of stent-remodeled (StR) and non-remodeled (nonR) coil embolization of intracranial aneurysms.

METHODS: Thirty-seven StR patients with FU digital subtraction angiography (DSA) were matched with 37 nonR patients according to presentation (ruptured or unruptured), location of the aneurysm (sidewall or bifurcation), initial sac occlusion (complete/near complete or incomplete/failure), and the sac size (largest diameter/less than 2 mm difference). The baseline clinical and aneurysm characteristics, initial/FU treatment success rates, and FU DSA findings between the StR and nonR groups with regard to the morphologic features (size and location) of the aneurysms were assessed and compared.

RESULTS: The StR group showed more frequent progressive thrombosis compared to the nonR group (56.8 vs. 27.0%; p < 0.05). These differences were more prominent for small aneurysms (70 vs. 25%; p < 0.05). Small aneurysms showed a lower rate of FU recanalization in the StR group compared to the nonR group (0 vs. 25%; p < 0.05). Sidewall aneurysms also showed a higher rate of progressive thrombosis in the StR group (61.1 vs. 27.8%; p < 0.05).

CONCLUSIONS: Coil embolization is an effective treatment method for intracranial aneurysms, however, changes on follow-up may affect the long-term outcome. Stent remodeling may aid in preserving and enhancing the treatment durability especially in small aneurysms.
Full Text
http://link.springer.com/article/10.1007%2Fs00701-009-0522-z
DOI
10.1007/s00701-009-0522-z
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Lee, Jae Whan(이재환)
Huh, Seung Kon(허승곤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101265
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