• Neurosurgery · Sep 2020

    Comparative Study Observational Study

    Comparison of Low-Profiled Visualized Intraluminal Support Stent-Assisted Coiling and Coiling Only for Acutely Ruptured Intracranial Aneurysms: Safety and Efficacy Based on a Propensity Score-Matched Cohort Study.

    • Gaici Xue, Qiao Zuo, Haishuang Tang, Xiaoxi Zhang, Guoli Duan, Zhengzhe Feng, Qiang Li, Pengfei Yang, Yibin Fang, Kaijun Zhao, Dongwei Dai, Yi Xu, Bo Hong, Qinghai Huang, Rui Zhao, and Jianmin Liu.
    • Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
    • Neurosurgery. 2020 Sep 1; 87 (3): 584-591.

    BackgroundLow-profiled visualized intraluminal support (LVIS) is suggested as a promising stent for complex intracranial aneurysms. However, the safety and efficacy of LVIS-assisted coiling of acutely ruptured wide-necked intracranial aneurysms have not been well reported.ObjectiveTo evaluate the safety and efficacy of LVIS-assisted coiling of acutely ruptured wide-necked intracranial aneurysms compared with contemporary coiling-only strategy via propensity score matching in a high-volume center.MethodsA retrospective review of patients with acutely ruptured intracranial aneurysms who underwent LVIS stent placement or coiling only from November 2013 to October 2017 was performed. Perioperative procedure-related complications and clinical and angiographic follow-up outcomes were compared.ResultsAll baseline characteristics were equivalent between the 2 groups except for neck size. The immediate angiographic results, procedure-related complications, procedure-related mortality, and clinical outcomes between the 2 groups demonstrated no significant differences (P = .087, P = .207, P = .685, and P = .865, respectively). The angiographic follow-up outcomes of the LVIS-assisted coiling group showed a significantly higher complete occlusion rate and lower recurrence rate compared with the coiling-only group (92.3% vs 59.9%, 4.8% vs 26.1%, P < .001). Multivariable analysis showed no significant predictors for the overall perioperative procedure-related complications, hemorrhagic complications, and ischemic complications.ConclusionThe LVIS stent is a safe and effective device for stent-assisted coiling of acutely ruptured wide-necked intracranial aneurysms, with comparable procedure-related complication rates, higher complete occlusion rates, and lower recurrence rates at follow-up compared with coiling only.Copyright © 2020 by the Congress of Neurological Surgeons.

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