The use of single stent-assisted coiling in treatment of bifurcation aneurysms: A multicenter cohort study with proposal of a scoring system to predict complete occlusion

Academic Article

Abstract

  • Copyright C 2017 by the Congress of Neurological Surgeons BACKGROUND: The development of stent-assisted coiling has allowed for the endovascular treatment of wide-necked bifurcation aneurysms. A variety of options exist, and little is known about the optimal stent configuration in this setting. We report a large multicenter experience of stent-assisted coiling of bifurcations aneurysms using a single stent, with attention to factors predisposing to aneurysm recanalization. OBJECTIVE: To assess the safety and efficacy of single stent-assisted coiling, in addition to analyzing the factors associated with recanalization, and proposal of a predictive scoring scale. METHODS: A multicenter retrospective analysis of bifurcation aneurysms treated with a single stent-assisted coiling technique between 2007 and 2015 was performed. Clinical and radiographic data were collected and used to develop a scoring system to predict aneurysm occlusion. RESULTS: A total of 74 bifurcation aneurysms were treated with single stent-assisted coiling. At a median follow-up of 15.2 mo, complete occlusion or remnant neck was achieved in 90.6% of aneurysms. Aneurysm location, maximal diameter, neck size, and alpha angle were predictive of aneurysm occlusion at last follow-up. A scoring system to predict complete occlusion based on these factors was developed. An increasing score correlated with a higher rate of complete occlusion. CONCLUSION: The treatment of bifurcation aneurysm using single stent technique for stent-assisted coiling is safe and effective. Complete occlusion or remnant neck occlusion was achieved in 90.6% of cases. Class III aneurysms can be effectively treated using a single stent, while class I may require Y-stent technique.
  • Authors

    Digital Object Identifier (doi)

    Author List

  • Adeeb N; Griessenauer CJ; Patel AS; Foreman PM; Baccin CE; Moore JM; Gupta R; Alturki A; Harrigan MR; Ogilvy CS
  • Start Page

  • 710
  • End Page

  • 718
  • Volume

  • 82
  • Issue

  • 5