Yisen Zhang1, Ming Yang2, Hongqi Zhang3, Xiaolong Zhang4, Youxiang Li1, Chuhan Jiang1, Jian Liu5, Xinjian Yang6. 1. Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China. 2. Department of Neurosurgery, Wuhan General Hospital, Guangzhou Military Command of PLA, Wuhan, China. 3. Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China. 4. Department of Radiology, Huashan Hospital Affiliated to Fudan University, Shanghai, China. 5. Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China. Electronic address: jianliu_ns@163.com. 6. Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China. Electronic address: yang-xj@163.net.
Abstract
OBJECTIVE: To evaluate the safety and efficacy of endovascular treatments, including stent-assisted coiling, of very small (≤3 mm), ruptured intracranial aneurysms. METHODS: Ninety-three endovascularly treated patients with very small ruptured aneurysms were recruited from 4 high-volume centers between September 2010 and February 2014. Factors influencing procedural complications and outcomes were analyzed. RESULTS: Fifty-one (54.8%) aneurysms were treated by stent-assisted coiling, 41 (44.1%) by coiling alone, and 1 (1.1%) by balloon-assisted coiling. Intraprocedural or postprocedural complications occurred in 13 patients (14.0%): coil migration in 1, intraprocedural rupture in 1, hydrocephalus in 6, and ischemic event in 1. No tested factor was able to predict procedural complications. Angiographic follow-up of 67 aneurysms (72%) revealed recurrence in 5 patients (7.5%). One recurrent case was treated initially by stent-assisted coiling and the remaining four by coiling alone (P = 0.044). Multivariate regression analysis showed that coiling alone was significantly associated with aneurysm recurrence (odds ratio, 13.8; 95% confidence interval, 1.1-175.3; P = 0.043). CONCLUSIONS: Endovascular treatment of very small ruptured aneurysms was safe and effective and was not associated with a high rate of intraprocedural rupture. Treatment with the use of stents significantly lowered the recurrence rate without additional risks.
OBJECTIVE: To evaluate the safety and efficacy of endovascular treatments, including stent-assisted coiling, of very small (≤3 mm), ruptured intracranial aneurysms. METHODS: Ninety-three endovascularly treated patients with very small ruptured aneurysms were recruited from 4 high-volume centers between September 2010 and February 2014. Factors influencing procedural complications and outcomes were analyzed. RESULTS: Fifty-one (54.8%) aneurysms were treated by stent-assisted coiling, 41 (44.1%) by coiling alone, and 1 (1.1%) by balloon-assisted coiling. Intraprocedural or postprocedural complications occurred in 13 patients (14.0%): coil migration in 1, intraprocedural rupture in 1, hydrocephalus in 6, and ischemic event in 1. No tested factor was able to predict procedural complications. Angiographic follow-up of 67 aneurysms (72%) revealed recurrence in 5 patients (7.5%). One recurrent case was treated initially by stent-assisted coiling and the remaining four by coiling alone (P = 0.044). Multivariate regression analysis showed that coiling alone was significantly associated with aneurysm recurrence (odds ratio, 13.8; 95% confidence interval, 1.1-175.3; P = 0.043). CONCLUSIONS: Endovascular treatment of very small ruptured aneurysms was safe and effective and was not associated with a high rate of intraprocedural rupture. Treatment with the use of stents significantly lowered the recurrence rate without additional risks.