{"title":"Outcomes of stent-assisted coil embolization of intracranial aneurysms with a small parental vessel diameter.","authors":"Shunsaku Goto, Takashi Izumi, Masahiro Nishihori, Shinsuke Muraoka, Keita Suzuki, Yuichi Kawasaki, Kai Takayanagi, Issei Takeuchi, Ryuta Saito","doi":"10.1177/15910199251339891","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundStent-assisted coil embolization (SACE) is widely used for treating cerebral aneurysms, particularly bifurcation aneurysms. Although stents are typically indicated for parent vessels larger than 2 mm, their use in small-diameter vessels (<2 mm) hasn't been extensively studied. This study evaluates the safety of SACE with small-diameter vessels.MethodsThis retrospective study analyzed 324 patients who underwent SACE between 2010 and 2023. Patients were divided into the small-diameter (SD) group (<2 mm, n = 100) and the normal diameter (ND) group (> 2 mm, n = 224). Perioperative ischemic complications and their risk factors were compared between the two groups.ResultsIntraoperative thrombi occurred in 6 patients (6.0%) in the SD group, with 4 (4.0%) asymptomatic and 2 (2.0%) transiently symptomatic. In the ND group, thrombi occurred in 7 patients (3.1%), with 5 (2.2%) asymptomatic and 1 (0.4%) experiencing worsened modified Rankin Scale (mRS). Symptomatic ischemic complications occurred in 5 patients (5.0%) in the SD group and 22 patients (9.8%) in the ND group, with 2 (2.0%) and 7 (3.1%) showing worsened mRS, respectively. A neck diameter > 5.5 mm was identified as a risk factor for perioperative ischemic complications.ConclusionSACE can be safely performed in patients with SD parent vessels without increasing ischemic complications. However, there was only a trend toward higher frequency of intraoperative thrombi in the SD group, highlighting the need for preventive measures and prompt intervention. Having a wide neck diameter > 5.5 mm was identified a risk factor for periprocedural ischemic complications in the SD group.</p>","PeriodicalId":49174,"journal":{"name":"Interventional Neuroradiology","volume":" ","pages":"15910199251339891"},"PeriodicalIF":2.1000,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370665/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Interventional Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/15910199251339891","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
BackgroundStent-assisted coil embolization (SACE) is widely used for treating cerebral aneurysms, particularly bifurcation aneurysms. Although stents are typically indicated for parent vessels larger than 2 mm, their use in small-diameter vessels (<2 mm) hasn't been extensively studied. This study evaluates the safety of SACE with small-diameter vessels.MethodsThis retrospective study analyzed 324 patients who underwent SACE between 2010 and 2023. Patients were divided into the small-diameter (SD) group (<2 mm, n = 100) and the normal diameter (ND) group (> 2 mm, n = 224). Perioperative ischemic complications and their risk factors were compared between the two groups.ResultsIntraoperative thrombi occurred in 6 patients (6.0%) in the SD group, with 4 (4.0%) asymptomatic and 2 (2.0%) transiently symptomatic. In the ND group, thrombi occurred in 7 patients (3.1%), with 5 (2.2%) asymptomatic and 1 (0.4%) experiencing worsened modified Rankin Scale (mRS). Symptomatic ischemic complications occurred in 5 patients (5.0%) in the SD group and 22 patients (9.8%) in the ND group, with 2 (2.0%) and 7 (3.1%) showing worsened mRS, respectively. A neck diameter > 5.5 mm was identified as a risk factor for perioperative ischemic complications.ConclusionSACE can be safely performed in patients with SD parent vessels without increasing ischemic complications. However, there was only a trend toward higher frequency of intraoperative thrombi in the SD group, highlighting the need for preventive measures and prompt intervention. Having a wide neck diameter > 5.5 mm was identified a risk factor for periprocedural ischemic complications in the SD group.
期刊介绍:
Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...