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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(04): 821-827
DOI: 10.4103/ajns.AJNS_57_20
Review Article

Stent-assisted coiling of unruptured intracranial aneurysms with wide neck

Filippos Papadopoulos
Department of Neurosurgery, “KAT” General Hospital, Athens
,
Constantine Antonopoulos
1   Department of Vascular Surgery, School of Medicine, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens
,
George Geroulakos
1   Department of Vascular Surgery, School of Medicine, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens
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Objective: Morbidity and mortality in patients experiencing the rupture of intracranial aneurysm ruptures are high. We conducted a systematic review and meta-analysis to investigate the role of stent-assisted coiling (SAC) for unruptured intracranial aneurysms (UIAs) with wide neck. Materials and Methods: The current meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled proportions with 95% confidence intervals (CIs) of ten outcomes of interest were calculated. Results: We finally reviewed 13 studies, including 976 patients. The technical success of the method was 98.43% (95% CI: 95.62–99.95). Early outcomes included total periprocedural obliteration with a rate of 50.20% (95% CI: 36.09–64.30) and periprocedural rupture with zero rate. During the follow-up period, ranging from 6 months to 2 years, the total postprocedural obliteration rate was 63.83% (95% CI: 45.80–80.18) and the overall late rupture rate was 0.41% (95% CI: 0.00–2.38). The pooled in-stent stenosis rate was calculated at 1.24% (95% CI: 0.02–3.63). We also estimated a pooled rate of 0.02% (95% CI: 0.00–0.51) and 4.33% (95% CI: 2.03–7.23) for total mortality and overall neurological complications, respectively. A pooled rate of 3.94% (95% CI: 1.48–7.33) was found for stroke. Finally, the recanalization rate was recorded at 7.07% (95% CI: 4.35–10.26). Conclusions: SAC of UIAs with wide neck seems to be a safe and acceptable alternative to surgical clipping. Although early results concerning total periprocedural obliteration may be modest, follow-up outcomes may be indicative of adequate occlusion of treated UIAs.

Key-words:

Intracranial aneurysm - stent-assisted coiling - wide neck

Financial support and sponsorship

Nil.




Publication History

Received: 15 February 2020

Accepted: 25 April 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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