Stent-assisted coil embolization for ruptured anterior circulation intracranial aneurysms:comparison with non-stent-assisted coil embolization / 国际脑血管病杂志

ABSTRACT

Objective To compare the safety and efficacy of stent-assisted and non-stent-assisted coil embolization for the treatment of ruptured anterior circulation aneurysms. Methods From January 2014 to September 2018, patients with ruptured anterior circulation aneurysms treated with interventional embolization in Dezhou People ' s Hospital were enrolled retrospectively. The incidence of perioperative complications, mortality, and clinical outcome at 30 d after coil embolization were compared between the stent-assisted embolization group and the non-stent-assisted embolization group. Multivariate logistic regression analysis was used to determine the independent risk factors for poor outcomes. Results A total of 115 aneurysms were included in 115 patients. There were 47 patients in the stent-assisted embolization group (16 males, aged 56. 81 ±10. 16 years) and 68 in the non-stent-assisted embolization group (27 males, aged 52. 38 ± 9. 60 years ). There were no significant differences in the demographic and baseline data between the stent-assisted embolization group and the non-stent-assisted embolization group. There were no significant differences in the incidence of bleeding complications, ischemic complications, and symptomatic cerebral vasospasm as well. However, the overall complication rate (34. 04％ vs. 17. 65％; P = 0. 044), poor outcome rate (27. 66％ vs. 10. 29％; P = 0. 016 ), and mortality (14. 89％ vs. 2. 94％; P = 0. 046 ) in stent-assisted embolization group were significantly higher than those in the non-stent assisted embolization group. Multivariate logistic regression analysis indicated that hypertension (odds ratio [OR] 6. 000, 95％ confidence interval [CI] 1. 361-27. 363; P = 0. 021), diabetes (OR 6. 000, 95％ CI 1. 548-23. 255; P = 0. 010), stent-assist technique (OR 12. 201, 95％ CI 2. 588-102. 002; P = 0. 002), perioperative bleeding complications (OR 40. 286, 95％ CI 4. 508-360. 032; P = 0. 001), and ischemic complications (OR 46. 000, 95％ CI 10. 716-197. 460; P < 0. 001) were the independent risk factors for poor outcomes. Conclusion Stent-assisted coil embolization for ruptured anterior circulation aneurysms has a high incidence of complications and poor clinical outcomes, and should be avoided as much as possible.