Lukas Goertz1,2, Michael Artur Smyk3, Eberhard Siebert4, Bernd Turowski3, Jan Borggrefe5, Anastasios Mpotsaris6, Georg Bohner4, Marc Schlamann5, Franziska Dorn7, Thomas Liebig7, Christoph Kabbasch5. 1. Department of Neuroradiology, University Hospital of Cologne, Kerpener Str. 67, 50937, Cologne, Germany. lukas.goertz@uk-koeln.de. 2. Center for Neurosurgery, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Str. 67, 50937, Cologne, Germany. lukas.goertz@uk-koeln.de. 3. Department of Neuroradiology, University Hospital of Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. 4. Institute of Neuroradiology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. 5. Department of Neuroradiology, University Hospital of Cologne, Kerpener Str. 67, 50937, Cologne, Germany. 6. Department of Neuroradiology, University Hospital of Aachen, Pauwelsstr. 30, 52074, Aachen, Germany. 7. Department of Neuroradiology, LMU University Hospital of Munich, Marchioninistr. 15, 81377, Munich, Germany.
Abstract
PURPOSE: Low-profile intracranial stents are characterized by a miniaturized design that enables deployment via a 0.0165″ or 0.017″ internal diameter microcatheter, which is typically intended for coil delivery. This study analyzed the incidence, clinical relevance and risk factors of thromboembolic events (TEE) occurring during low-profile stent-assisted coiling of intracranial aneurysms. METHODS: This was a retrospective, multicenter analysis of consecutive patients who underwent stent-assisted aneurysm coiling (SAC) with the laser-cut Acandis Acclino and Neuroform Atlas stents. The study evaluated the incidence of symptomatic and asymptomatic TEEs and the impact on functional outcome. Risk factors for TEEs were determined by univariate and bivariate logistic regression analyses. RESULTS: Among 131 procedures (mean patient age 56.5 ± 12.8 years, mean aneurysm size: 6.7 ± 3.9 mm) TEEs occurred in 14 cases (10.7%) of which 2 patients (1.5%) developed ischemic stroke, while the remaining TEEs remained asymptomatic. Multivariate analysis revealed Y‑stenting as potential risk factor for TEEs (odds ratio: 3.9, 95% confidence interval: 1.0-16.5; p = 0.08). CONCLUSION: The use of SAC with low-profile intracranial stents is associated with a favorable safety profile; however, Y‑stenting may carry an increased risk of TEEs, which needs to be considered during treatment planning.
PURPOSE: Low-profile intracranial stents are characterized by a miniaturized design that enables deployment via a 0.0165″ or 0.017″ internal diameter microcatheter, which is typically intended for coil delivery. This study analyzed the incidence, clinical relevance and risk factors of thromboembolic events (TEE) occurring during low-profile stent-assisted coiling of intracranial aneurysms. METHODS: This was a retrospective, multicenter analysis of consecutive patients who underwent stent-assisted aneurysm coiling (SAC) with the laser-cut Acandis Acclino and Neuroform Atlas stents. The study evaluated the incidence of symptomatic and asymptomatic TEEs and the impact on functional outcome. Risk factors for TEEs were determined by univariate and bivariate logistic regression analyses. RESULTS: Among 131 procedures (mean patient age 56.5 ± 12.8 years, mean aneurysm size: 6.7 ± 3.9 mm) TEEs occurred in 14 cases (10.7%) of which 2 patients (1.5%) developed ischemic stroke, while the remaining TEEs remained asymptomatic. Multivariate analysis revealed Y‑stenting as potential risk factor for TEEs (odds ratio: 3.9, 95% confidence interval: 1.0-16.5; p = 0.08). CONCLUSION: The use of SAC with low-profile intracranial stents is associated with a favorable safety profile; however, Y‑stenting may carry an increased risk of TEEs, which needs to be considered during treatment planning.
Authors: Lukas Goertz; Michael A Smyk; Anastasios Mpotsaris; Jan Borggrefe; Franziska Dorn; Thomas Liebig; Marc Schlamann; Kai Laukamp; Boris Krischek; Bernd Turowski; Christoph Kabbasch Journal: Clin Neuroradiol Date: 2019-11-15 Impact factor: 3.649
Authors: J-K Burkhardt; V Srinivasan; A Srivatsan; F Albuquerque; A F Ducruet; B Hendricks; B A Gross; B T Jankowitz; A J Thomas; C S Ogilvy; G A Maragkos; A Enriquez-Marulanda; R W Crowley; M R Levitt; L J Kim; C J Griessenauer; C M Schirmer; S Dalal; K Piper; M Mokin; E A Winkler; A A Abla; C McDougall; L Birnbaum; J Mascitelli; M Litao; O Tanweer; H Riina; J Johnson; S Chen; P Kan Journal: AJNR Am J Neuroradiol Date: 2020-05-28 Impact factor: 3.825