E-112 endovascular coil embolization versus stent-assisted coil embolization of complex internal carotid artery aneurysms: long-term follow-up of treatment effectiveness

Abstract

Introduction/purpose Compare the outcomes of coil embolization alone (CA) versus stent-assisted coil embolization (SAC) in aneurysms of internal carotid artery (ICA) with unfavorable anatomic characteristics. Materials and methods Institutional Review Board approval was obtained for this study. Retrospective review of the patient registry containing 767 patients with 1,170 aneurysms was performed. Inclusion criteria: 1. Previously untreated aneurysm internal carotid artery aneurysm 2. Complex morphology: Neck size of ≥4mm or a dome to neck ratio Results Patients characteristics and number of aneurysms treated did not differ significantly between the two groups. Aneurysm baseline characteristics in the two groups are similar except for significantly wide neck size in SAC group (CA: 4.4 ± 1.7 versus SAC: 5.5 ± 1.8, P = 0.003). No significant change between the study groups demonstrated for safety end-point (p = 0.99). In spite of similar effectiveness in both the CA and SAC groups at immediate post treatment phase (n = 18 (45%) vs. n = 18 (41.9%) respectively, P = 0.827) and at 6-months follow-up (n = 17 (58.6%) vs. n = 24 (70.6%) respectively, P = 0.428), patients in the SAC group shows significantly higher effectiveness (n = 13 (43.3%) vs. n = 26 (68.4%), P = 0.038, in the CA vs. SAC groups respectively) beyond 6 months. Conclusion Stent-assisted coil embolization in unruptured complex internal carotid artery aneurysms with an unfavorable anatomy offers a more effective long-term treatment option while having a similar safety profile to coil embolization alone. Disclosures S. Boddu: None. A. Banihashemi: None. P. Gobin: None. J. Knopman: None. A. Patsalides: None.