BACKGROUND: Recent reports have shown that stent-assisted coiling (SAC) is associated with lower aneurysm recanalization rates compared with conventional coiling, raising questions about the necessity of achieving high packing density (PD) in stented aneurysms. OBJECTIVE: To assess the impact of PD on follow-up obliteration rates of stented aneurysms and attempt to determine the optimal range of PD in SAC. METHODS: This is a retrospective analysis of a single, large, cerebrovascular referral center's experience over a 5-year period in SAC with the use of Neuroform and Enterprise stents. The rate of complete obliteration on follow-up angiograms was compared for 3 different PD groups: high PD (>22%), moderate PD (12-22%), and low PD (<12%). RESULTS: There were 292 stent-coiled aneurysms (36 ruptured, 256 unruptured) with available angiographic follow-up. Mean PD was 15.2%, and complete obliteration rate was 79.5% at latest follow-up. The rates of complete obliteration were significantly higher in the moderate (86.4%; OR = 2.58; P = .006) and high PD groups (85.3%; OR = 2.35; P = .037) compared with the low PD group (71.1%). However, no statistically significant difference was found between the moderate and high PD groups (OR = 0.91; P = .84). In multivariate analysis, PD was a significant predictor of complete obliteration (P = .007) along with smaller aneurysm volumes (P = .004). Ruptured (P = .002) and cavernous aneurysms (P < .001) had significantly lower obliteration rates. CONCLUSION: High obliteration rates at follow-up were observed despite modest packing of stented aneurysms. Although PD is a definite factor in SAC, moderate and high packing of stented aneurysms seems to provide equivalent angiographic obliteration rates at follow-up.
BACKGROUND: Recent reports have shown that stent-assisted coiling (SAC) is associated with lower aneurysm recanalization rates compared with conventional coiling, raising questions about the necessity of achieving high packing density (PD) in stented aneurysms. OBJECTIVE: To assess the impact of PD on follow-up obliteration rates of stented aneurysms and attempt to determine the optimal range of PD in SAC. METHODS: This is a retrospective analysis of a single, large, cerebrovascular referral center's experience over a 5-year period in SAC with the use of Neuroform and Enterprise stents. The rate of complete obliteration on follow-up angiograms was compared for 3 different PD groups: high PD (>22%), moderate PD (12-22%), and low PD (<12%). RESULTS: There were 292 stent-coiled aneurysms (36 ruptured, 256 unruptured) with available angiographic follow-up. Mean PD was 15.2%, and complete obliteration rate was 79.5% at latest follow-up. The rates of complete obliteration were significantly higher in the moderate (86.4%; OR = 2.58; P = .006) and high PD groups (85.3%; OR = 2.35; P = .037) compared with the low PD group (71.1%). However, no statistically significant difference was found between the moderate and high PD groups (OR = 0.91; P = .84). In multivariate analysis, PD was a significant predictor of complete obliteration (P = .007) along with smaller aneurysm volumes (P = .004). Ruptured (P = .002) and cavernous aneurysms (P < .001) had significantly lower obliteration rates. CONCLUSION: High obliteration rates at follow-up were observed despite modest packing of stented aneurysms. Although PD is a definite factor in SAC, moderate and high packing of stented aneurysms seems to provide equivalent angiographic obliteration rates at follow-up.
Authors: Jimmy Ghostine; Naim Khoury; Francis Cloutier; Marc Kotowski; Jean-Christophe Gentric; André L Batista; Alain Weill; Daniel Roy; Tim E Darsaut; Jean Raymond Journal: Interv Neuroradiol Date: 2016-08-16 Impact factor: 1.610
Authors: T Ohta; I Nakahara; R Ishibashi; S Matsumoto; M Gomi; H Miyata; H Nishi; S Watanabe; I Nagata Journal: AJNR Am J Neuroradiol Date: 2014-12-26 Impact factor: 3.825
Authors: Mario Zanaty; Nohra Chalouhi; Stavropoula I Tjoumakaris; Robert H Rosenwasser; Pascal M Jabbour Journal: Transl Stroke Res Date: 2013-11-24 Impact factor: 6.829
Authors: Olli I Tähtinen; Hannu I Manninen; Ritva L Vanninen; Riitta Rautio; Arto Haapanen; Janne Seppänen; Tero Niskakangas; Jaakko Rinne; Leo Keski-Nisula Journal: Neuroradiology Date: 2013-07-17 Impact factor: 2.804
Authors: N Chalouhi; R M Starke; M T Koltz; P M Jabbour; S I Tjoumakaris; A S Dumont; R H Rosenwasser; S Singhal; L F Gonzalez Journal: AJNR Am J Neuroradiol Date: 2013-05-02 Impact factor: 3.825
Authors: Mario Zanaty; Nohra Chalouhi; Stavropoula I Tjoumakaris; L Fernando Gonzalez; Robert Rosenwasser; Pascal Jabbour Journal: Neuroradiology Date: 2014-02-18 Impact factor: 2.804
Authors: Aglaé Velasco González; P Stracke; H Nordmeyer; M Heddier; S Saleme; C Sauerland; S Berkemeyer; B Buerke; W Heindel; R Chapot Journal: Neuroradiology Date: 2018-09-05 Impact factor: 2.804