Comparison of stent-assisted and non-stent-assisted coils in the treatment of ruptured wide-necked anterior communicating artery aneurysm in acute stage

Abstract

Objective To compare the safety and efficacy of stent-assisted and non-stent-assisted coil embolization in the treatment of anterior communicating ruptured wide-necked aneurysms in acute phase. Methods The clinical data of 76 patients with anterior traffic rupture wide-necked aneurysm treated by interventional embolism from January 2014 to December 2018 were collected in the People's Hospital of Dezhou.According to whether or not stents were assisted during the operation, 76 cases were divided into stent group (41 cases) and non-stent group (35 cases). The stent group selected the Solitaire AB neurovascular remodoring device or the LVIS support for the corresponding size according to the diameter of the patients’ artery, and the non-stent group used a single catheter, a double catheter, or a balloon assist.The perioperative complications, mortality and clinical prognosis between the two groups were compared. Results There were no statistically significant differences in bleeding complications, symptomatic vasospasm, mortality and clinical prognosis between the two groups (all P>0.05). The incidence of ischemic complications in the stent group was 17.07%(7/41), which was significantly higher than that in the non-stent group[2.86%(1/35)](χ2=4.052, P<0.05). The overall complication rate of the stent group was 21.95%(9/41), which was significantly higher than 5.71%(2/35) of the non-stent group (χ2=4.021, P<0.05). Conclusion Both stent-assisted and non-stent-assisted coils can achieve good clinical results in the treatment of anterior communicating ruptured wide-necked aneurysms in acute phase.Stent-assisted embolism has a high incidence of ischemic complications and needs caution in clinical application. Key words: Intracranial aneurysm; Subarachnoid hemorrhage; Embolization, therapeutic; Tissue scaffolds; Postoperative complications; Prognosis