• Hongchao Yang, Yong Sun, Yuhua Jiang, Xianli Lv, Yang Zhao, Youxiang Li, and Aihua Liu.
• Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
• Neurosurgery. 2015 Aug 1;77(2):241-7; discussion 247.

BackgroundStent-assisted coiling has been used in both unruptured and ruptured aneurysms, but the safety and efficacy still remain controversial.ObjectiveTo compare the safety and efficacy of stent-assisted coiling with coiling alone for intracranial aneurysms.MethodsWe retrospectively reviewed 512 patients treated by endovascular coiling or stent-assisted coiling over a 1-year period. The patients' clinical and imaging information was recorded. Procedure-related complication rates, recurrence rates, and clinical outcomes were analyzed in both the total aneurysms and the subgroups of ruptured and unruptured aneurysms.ResultsA total of 243 patients were treated by coiling alone and 269 patients were treated by stent-assisted coiling. Procedure-related complications occurred in 6.2% of patients in the coiling-alone group compared with 6.3% in the stent-assisted coiling group. The procedural permanent morbidity and mortality rates were 1.6% (4/243) and 1.2% (3/243), respectively, in the coiling-alone group and 1.1% (3/269) and 1.5% (4/269), respectively, in the stent-assisted coiling group. A significantly lower recurrence rate was found in the stent-assisted coiling group compared with the coiling-alone group (5.2% vs 16.5%, P = .002). In a comparison of subgroups of ruptured and unruptured aneurysms, the procedural complications rates were comparable in the 2 groups, with a lower recurrence rate in the stent-assisted coiling group. Multivariate analysis showed that larger aneurysm size and higher Hunt and Hess grade were predictors of procedural morbidity; larger aneurysm size, ruptured aneurysm, anterior circulation aneurysms, initial incomplete occlusion, and lack of stent assistance were predictors of recurrence.ConclusionCompared with coiling alone, stent-assisted coiling may achieve lower recurrence rates, with comparable procedure-related complications and clinical outcomes in both ruptured and unruptured aneurysms.

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