Stent-assisted aneurysm coil embolization: safety and efficacy at a low-volume center

Abstract

Background and purpose: To compare safety and efficacy of cerebral aneurysm embolization with and without Neuroform stent placement at a low procedural volume center.Methods: Retrospective cohort study of unruptured aneurysm coil embolization with and without Neuroform stent assistance over a period of 53 months at a center performing 14·4 interventions per year. Neuroform stent-assisted embolization was performed for 26 aneurysms in 25 patients (mean age: 61·3 years). Twelve patients (mean age: 64·3 years) with 12 unruptured aneurysms were treated without stent support. Comparative analysis of complications, angiographic findings, and clinical outcomes was performed.Results: Procedural complications for the Neuroform stent group was 7·69% (2/26) versus 8·34% (1/12) for aneurysms without (P=0·7; OR: 1·1; CI: 0·09-13·35).The Modified Rankin Scale (MRS) and Glasgow Outcome Scale (GOS) scores for all patients in the stent and non-stent groups were 0 and 5, respectively. Three out of 20 aneurysms (15%) were retreated for major recurrence in the stent group and two of 10 (20%) in the non-stent group (P=0·55; OR: 1·42; 95% CI: 0·20-10·23). At a mean follow-up of 16·9 months, persistent complete occlusion was observed in 36·8% (7/19) of aneurysms with stent support. At a mean of 15·9-month follow-up in 10 non-stented aneurysms, persistent complete occlusion was observed in 50% of aneurysms (P=0·69; OR=2·3; 95% CI: 0·38-14·2).Conclusion: Neuroform stent-assisted coil embolization at a low volume center is efficacious and does not increase procedural risk with optimal operator experience.