• Ming-Tao Feng, Wan-Ling Wen, Zheng-Zhe Feng, Yi-Bin Fang, Jian-Min Liu, and Qing-Hai Huang.
• Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
• World Neurosurg. 2016 Sep 1; 93: 271-8.

ObjectivesWe sought to review the literature concerning stent-assisted coiling (SAC) in comparison with coiling without stents for treating intracranial aneurysms and to evaluate the safety and effectiveness of SAC by conducting a meta-analysis of published studies.MethodsAccording to the methods and guidelines for meta-analysis, PubMed, Embase, and Cochrane Database were searched. All articles that compared SAC and coiling without stent were reviewed. The data extracted were the rates of immediate occlusion, progressive thrombosis, angiographic occlusion, angiographic recurrence, overall complications, ischemic stroke, and hemorrhagic stroke.ResultsSixteen studies with 4294 aneurysms were analyzed. SAC was performed for 1466 aneurysms; and coiling without stent was performed for 2828 aneurysms. No significant difference in immediate occlusion rate was found between the 2 groups (odds ratio [OR] = 1.01; 95% confidence interval [CI], 0.73-1.39, P = 0.96). However, SAC had an advantage in terms of angiographic occlusion rate during follow-up (OR = 1.62, 95% CI: 1.16-2.26, P < 0.01), progressive thrombosis rate (OR = 2.54, 95% CI: 2.00-3.24, P < 0.01), and reduction in recurrence rate (OR = 0.46; 95% CI, 0.35-0.59, P < 0.01). No significant differences were shown in overall complication rate (OR = 1.30, 95% CI: 086-1.96, P = 0.21) and hemorrhagic stroke rate (OR = 0.72, 95% CI: 0.43-1.20, P = 0.21). Ischemic strokes were more common in the SAC patients than in the non-stent-assisted patients (OR = 1.66; 95% CI: 1.05-2.63, P = 0.03).ConclusionCompared with coiling without stent, stent-assisted coiling of intracranial aneurysms achieved satisfactory results, with higher long-term angiographic occlusion rate and lower recurrence rate. However, ischemic stroke remains a problem that cannot be ignored.Copyright © 2016 Elsevier Inc. All rights reserved.

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