TY - JOUR
T1 - Long-term follow-up of aneurysms treated electively with woven stent-assisted coiling
AU - Cheung, Nicholas K
AU - Chiu, Albert Hy
AU - Cheung, Andrew K
AU - Wenderoth, Jason D
PY - 2018/7/1
Y1 - 2018/7/1
N2 - BACKGROUND: Preliminary short-term results for stent-assisted coil embolization (SACE) using woven/braided stents have been promising. However, evidence supporting mid- to long-term efficacy and durability is lacking.OBJECTIVE: To report the long-term results for the durability of elective intracranial aneurysms treated with woven stents.MATERIALS AND METHODS: Between May 2012 and May 2015, 98 consecutive patients with 103 aneurysms underwent elective woven SACE across three Australian neurovascular centres. All patients had immediate, 6- and 18-month clinical and radiological follow-up. Radiological assessment was performed with modified Raymond-Roy occlusion scores based on angiography results, while clinical assessment was based on the modified Rankin Scale.RESULTS: Six-month follow-up was available in 100 aneurysms, and an 18-month follow-up in 97 aneurysms. Total occlusion rates of 82% were achieved at inception, 82% at 6 months, and 90% at 18 months. Satisfactory occlusion with small neck remnants was present in 17% at inception, 16% at 6 months, and 9% at 18 months. Good neurological outcomes were achieved in 95% at 18 months. Intraprocedural thromboembolic events were recorded in 3% and delayed events in 1% (all in patients taking clopidogrel). Aneurysm recurrence occurred in one patient (1%). Technical complications occurred in 5%. The total complication rate was 10%.CONCLUSIONS: Woven SACE is safe, efficacious, and durable at long-term 18-month follow-up, with very low recurrence and re-treatment rates. Preliminary results appear better than those for traditional laser-cut stents.
AB - BACKGROUND: Preliminary short-term results for stent-assisted coil embolization (SACE) using woven/braided stents have been promising. However, evidence supporting mid- to long-term efficacy and durability is lacking.OBJECTIVE: To report the long-term results for the durability of elective intracranial aneurysms treated with woven stents.MATERIALS AND METHODS: Between May 2012 and May 2015, 98 consecutive patients with 103 aneurysms underwent elective woven SACE across three Australian neurovascular centres. All patients had immediate, 6- and 18-month clinical and radiological follow-up. Radiological assessment was performed with modified Raymond-Roy occlusion scores based on angiography results, while clinical assessment was based on the modified Rankin Scale.RESULTS: Six-month follow-up was available in 100 aneurysms, and an 18-month follow-up in 97 aneurysms. Total occlusion rates of 82% were achieved at inception, 82% at 6 months, and 90% at 18 months. Satisfactory occlusion with small neck remnants was present in 17% at inception, 16% at 6 months, and 9% at 18 months. Good neurological outcomes were achieved in 95% at 18 months. Intraprocedural thromboembolic events were recorded in 3% and delayed events in 1% (all in patients taking clopidogrel). Aneurysm recurrence occurred in one patient (1%). Technical complications occurred in 5%. The total complication rate was 10%.CONCLUSIONS: Woven SACE is safe, efficacious, and durable at long-term 18-month follow-up, with very low recurrence and re-treatment rates. Preliminary results appear better than those for traditional laser-cut stents.
KW - Adult
KW - Aged
KW - Australia/epidemiology
KW - Blood Vessel Prosthesis/trends
KW - Elective Surgical Procedures/instrumentation
KW - Embolization, Therapeutic/instrumentation
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Intracranial Aneurysm/diagnostic imaging
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Retrospective Studies
KW - Self Expandable Metallic Stents/trends
KW - Thromboembolism/diagnostic imaging
KW - Time Factors
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=85044120360&partnerID=8YFLogxK
U2 - 10.1136/neurintsurg-2017-013402
DO - 10.1136/neurintsurg-2017-013402
M3 - Article
C2 - 29246908
SN - 1759-8478
VL - 10
SP - 673
EP - 678
JO - Journal of neurointerventional surgery
JF - Journal of neurointerventional surgery
IS - 7
ER -