• World Neurosurg · Jun 2019

    Multicenter Study

    Treatment of blood blister-like aneurysms with stent-assisted coiling: a retrospective multicenter study.

    • Yibin Fang, Deyuan Zhu, Ya Peng, Ming Zhong, Jing Xu, Qiuping Li, Guobiao Liang, Yang Wang, Wenfeng Feng, Donghai Wang, Yang Zhang, Dong Chen, Qingdong Guo, Tianxiao Li, Xiaodong Xie, Gang Zhu, Sheng Guan, Zhen Gu, Gang Li, Hua Yang, Xueyang He, Qin Zhu, Jieqing Wan, Qiang Li, Pengfei Yang, Rui Zhao, Qianghai Huang, Bo Hong, Yi Xu, and Jianmin Liu.
    • Department of Neurosurgery, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, China.
    • World Neurosurg. 2019 Jun 1; 126: e486-e491.

    ObjectiveTo clarify safety and efficacy of stent-assisted coiling for treatment of blood blister-like aneurysm (BBA) in a multicenter experience.MethodsA total of 212 consecutive cases (213 BBAs) treated with stent-assisted coiling were retrospectively reviewed and included in the final analysis. Outcomes including complete occlusion, recurrence, perioperative morbidity and mortality, and overall good neurologic outcome during follow-up were analyzed.ResultsOf 212 patients, 102 (48.1%) were treated with a single stent, 77 (36.3%) were treated with 2 stents, and 33 (15.6%) were treated with ≥3 stents. Angiographic follow-up data were available for 96 BBAs; 64.6% of BBAs showed complete obliteration, and 22.9% showed recurrence. Complete obliteration rates of patients treated with single, 2, and ≥3 stents were 42.9%, 78.4%, and 88.2%. Recurrence rates of patients treated with single, 2, and ≥3 stents were 38.1%, 13.5%, and 5.9%. Using ≥2 stents seemed to result in higher obliteration rates (P < 0.001) and lower recurrence rates (P = 0.002). Clinical follow-up data available for 180 patients showed 91.1% of patients had a good clinical outcome. No difference was found between the 3 stent treatments. There were 14 (6.6%) perioperative ischemic complications and 12 (5.7%) hemorrhagic complications, with 10 (4.7%) cases of perioperative deaths. Using ≥2 stents seemed to result in a lower perioperative hemorrhagic complication rate compared with single stent (P = 0.037).ConclusionsOur data support the use of overlapping (≥2) stents combined with coiling as a safe and effective therapeutic modality for BBA. Overlapping (≥2) stents may provide higher obliteration rate, lower recurrence rate, and lower perioperative hemorrhagic risk in treatment of BBA.Copyright © 2019 Elsevier Inc. All rights reserved.

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