Thromboembolic Complications of Stent-Assisted Coiling for Intracranial Aneurysms: A Single-Center Experience

Abstract

Corresponding author: Yu Sam Won Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea Tel: +82-2-2001-2159 Fax: +82-2-2001-2157 E-mail: yusam.won@samsung.com Objective: Thromboembolism is the most common complication in stent-assisted coiling (SAC) procedures. This study aimed to evaluate the incidence and risk factors of thromboembolic complication in patients who underwent SAC for intracerebral aneurysm. Methods: Between January 2006 and December 2017, 35 patients (35 aneurysms) in the acute phase of subarachnoid hemorrhage (SAH) underwent SAC without antiplatelet premedication. Additionally, 45 patients (48 unruptured aneurysms) underwent SAC with antiplatelet premedication. Baseline patient characteristics were compared between the unruptured and ruptured aneurysm groups. Risk factors of thromboembolic complications were also analyzed. Results: Thromboembolic complications occurred in 11 of 83 aneurysms treated with SAC, among which 3 occurred in 48 unruptured aneurysms (6.3%; p=0.046) and 8 occurred in 35 ruptured aneurysms (22.9%; p=0.046). However, there was no permanent morbidity due to thromboembolic complications in either group. Conclusion: The thromboembolic complication rate for SAC in patients with ruptured aneurysms was significantly higher than for those with unruptured aneurysms. However, there was no permanent morbidity of thromboembolic complications, there seems to be no reason to reluctant SAC due to the risk of thromboembolic complications in patients with SAH.