Clinical Article
Stent assisted coiling versus non-stent coiling for the management of ruptured intracranial aneurysms: A outcome comparison study
Chen Zhen, Zhang Song, Jin Yazhou, Liu Chao, Li Dongdong, Wang Linyu, Guo Xinbin, Xu Haowen, Guan Sheng
Published 2020-01-28
Cite as Chin J Neurosurg, 2020,36(01): 38-43. DOI: 10.3760/cma.j.issn.1001-2346.2020.01.010
Abstract
ObjectiveTo compare the safety and efficiency of stent assisted coiling (SAC) with non-SAC for the management of ruptured intracranial aneurysms.
MethodsA total of 1 217 patients with ruptured intracranial aneurysms who underwent endovascular treatment at Neurointervention Department of the First Affiliated Hospital of Zhengzhou University from January 2011 to January 2018 were retrospectively enrolled. Patients were categorized into SAC (n=631) and non-SAC (n=586) groups. We retrospectively analyzed the immediate postoperative occlusion degree and that at follow-up (based on Raymond scale) as well as perioperative complication rate in the two groups. The difference was considered as significant with P<0.05.
ResultsIn SAC group, the Raymond grades were grade Ⅰ in 65.0% (n=410), grade II in 29.9% (n=189) and grade Ⅲ in 5.0% (n=32), while those in non-SAC group were grade Ⅰ in 51.4% (n=301), grade Ⅱ in 36.0% (n=211) and grade Ⅲ in 12.6% (n=74), and the inter-group difference was significant (P<0.01). Postoperative rebleeding rate was 2.5% (n=16) in SAC group and 5.1% (n=30) in non-SAC group, and the rate of ischemic event was 6.3% (n=40) in SAC group and 3.1% (n=18) in non-SAC group, and those differences were significant (P<0.05). In both groups, the disability was 1.0% (n=6 in each group) and the mortality was 2.2%(n=14 in SAC and n=13 in non-SAC) without inter-group statistical difference (P>0.05). At 12 months post operation, DSA was performed in 227 cases of SAC group and 102 cases of non-SAC group. In SAC group, the Raymond grades were grade Ⅰ in 71.8% (n=163), grade Ⅱ in 22.9% (n=52) and grade Ⅲ in 5.3% (n=12), while those in non-SAC group were grade Ⅰ in 53.9 % (n=55), grade Ⅱ in 34.3% (n=35) and grade Ⅲ in 11.8% (n=12). The recurrence rate was 11.9% (n=27) in SAC group and 38.2% (n=39) in non-SAC group. Those inter-group differences were significant (P<0.01).
ConclusionsCompared with non-SAC, SAC is associated with higher occlusion rate, lower recurrence rate, lower rebleeding rate and relatively higher rate of ischemic event. However, mortality and disability rate between two groups do not seem to differ.
Key words:
Aneurysm, ruptured; Embolization, therapeutic; Stents; Treatment outcome; Coils
Contributor Information
Chen Zhen
Department of Neurointervention, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
Zhang Song
Department of Neurointervention, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
Jin Yazhou
Department of Neurointervention, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
Liu Chao
Department of Neurointervention, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
Li Dongdong
Department of Neurointervention, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
Wang Linyu
Department of Neurointervention, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
Guo Xinbin
Department of Neurointervention, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
Xu Haowen
Department of Neurointervention, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
Guan Sheng
Department of Neurointervention, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
