Stent assisted coiling versus non-stent coiling for the management of ruptured intracranial aneurysms: A outcome comparison study

Abstract

Objective To compare the safety and efficiency of stent assisted coiling (SAC) with non-SAC for the management of ruptured intracranial aneurysms. Methods A 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. Results In 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 0.05). 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). Conclusions Compared 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