Risk Factors of Recurrence after Stent(s)-Assisted Coiling of Intracranial Vertebrobasilar Dissecting Aneurysms: A Multicenter Study.

Kun Wang,Yisen Zhang,Hongqi Zhang,Jian Liu,Zhongbin Tian,Yang Wang,Jun Wang,Junfan Chen,Xinjian Yang

doi:10.3389/fneur.2017.00482

Abstract

We aimed to evaluate the risk factors of recurrence after stent(s)-assisted coiling (SAC) of intracranial vertebrobasilar dissecting aneurysms (VBDAs) based on 168 consecutive patients. Between January 2011 and December 2015, 168 consecutive patients with 170 intracranial VBDAs, which were treated by SAC, were recruited from four high-volume centers. We used multivariate logistic regression to examine factors that affected recurrence of VBDAs. The mean duration of clinical follow-up of the 168 patients was 7.81 months (range, 3-24 months). Of the 168 patients, 4 (2.38%) suffered from intraoperative complications and 16 (9.52%) had postoperative complications. Two (1.19%) had severe disability. Imaging follow-up was available for 168 patients (170 VBDAs), with a mean duration 7.81 months, and 24 (14.12%) cases of recurrence of aneurysms were noted. Aneurysm size and metal coverage of stent(s) at the neck were independent predictors of recurrence after SAC by logistic regression analysis. This multicenter cohort study shows that aneurysm size and the metal coverage of stent(s) at aneurysmal neck are independent factors associated with recurrence of VBDAs after SAC.

Highlights

Vertebrobasilar dissecting aneurysms (VBDAs) are uncommon lesions of which treatment is challenging and represent 3.3% of all intracranial aneurysms [1]
Angiographic follow-up was available for all 168 patients (170 VBDAs), with a mean duration of 7.81 months, and 24 (14.12%) aneurysm recurrences were observed
Univariate analysis showed that initial Raymond grade, aneurysm size, and metal coverage of the stent(s) at the aneurysm neck were related to the recurrence rate

Summary

Introduction

Vertebrobasilar dissecting aneurysms (VBDAs) are uncommon lesions of which treatment is challenging and represent 3.3% of all intracranial aneurysms [1]. Risk Factors of Recurrence about Intracranial VBDAs coiling [SAC] or stent only), has emerged as a major therapeutic option for VBDAs [6]. Identifying risk factors of VBDA recurrence after SAC is an important issue and would be helpful for endovascular treatment. This study aimed to identify risk factors of recurrence after SAC in a large multicenter sample of patients with VBDAs. This study aimed to identify risk factors of recurrence after SAC in a large multicenter sample of patients with VBDAs In this retrospective study, we examined baseline information, the details of endovascular treatment, and the clinical outcomes in 168 consecutive patients with VBDAs at four high-volume medical centers. We aimed to evaluate the risk factors of recurrence after stent(s)assisted coiling (SAC) of intracranial vertebrobasilar dissecting aneurysms (VBDAs) based on 168 consecutive patients

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