Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

Liu, Yinlong; Wang, Jianren; Lin, Lishan; Sang, Chunsheng; Lin, Zexi; Pan, Yaohua; Fu, Xi 'an

doi:10.12659/msm.911773

Cited by 10 publications

(7 citation statements)

References 17 publications

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“…The SMART ruptured aneurysm subgroup achieved occlusion comparable to other studies evaluating ruptured aneurysms treated with bare metal coils (24). Another study of ruptured aneurysms treated with coiling reported a periprocedural safety complication rate as high as 12.7% compared to 3.1% in the SMART Ruptured population (27). Therefore, SMART Coil appears to maintain safety and performance across multiple complex lesion types.…”

Section: Discussionsupporting

confidence: 56%

The SMART Registry: Long-Term Results on the Utility of the Penumbra SMART COIL System for Treatment of Intracranial Aneurysms and Other Malformations

et al. 2021

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Introduction: Penumbra SMART COIL® (SMART) System is a novel generation embolic coil with varying stiffness. The study purpose was to report real-world usage of the SMART System in patients with intracranial aneurysms (ICA) and non-aneurysm vascular lesions.Materials and Methods: The SMART Registry is a post-market, prospective, multicenter registry requiring ≥75% Penumbra Coils, including SMART, PC400, and/or POD coils. The primary efficacy endpoint was retreatment rate at 1-year and the primary safety endpoint was the procedural device-related serious adverse event rate.Results: Between June 2016 and August 2018, 995 patients (mean age 59.6 years, 72.1% female) were enrolled at 68 sites in the U.S. and Canada. Target lesions were intracranial aneurysms in 91.0% of patients; 63.5% were wide-neck and 31.8% were ruptured. Adjunctive devices were used in 55.2% of patients. Mean packing density was 32.3%. Procedural device-related serious adverse events occurred in 2.6% of patients. The rate of immediate post-procedure adequate occlusion was 97.1% in aneurysms and the rate of complete occlusion was 85.2% in non-aneurysms. At 1-year, the retreatment rate was 6.8%, Raymond Roy Occlusion Classification (RROC) I or II was 90.0% for aneurysms, and Modified Rankin Scale (mRS) 0-2 was achieved in 83.1% of all patients. Predictors of 1-year for RROC III or retreatment (incomplete occlusion) were rupture status (P < 0.0001), balloon-assisted coiling (P = 0.0354), aneurysm size (P = 0.0071), and RROC III immediate post-procedure (P = 0.0086) in a model that also included bifurcation aneurysm (P = 0.7788). Predictors of aneurysm retreatment at 1-year was rupture status (P < 0.0001).Conclusions: Lesions treated with SMART System coils achieved low long-term retreatment rates.Clinical Trial Registration:https://www.clinicaltrials.gov/, identifier NCT02729740.

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Section: Discussionsupporting

confidence: 56%

The SMART Registry: Long-Term Results on the Utility of the Penumbra SMART COIL System for Treatment of Intracranial Aneurysms and Other Malformations

et al. 2021

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“…SAC arises in response to the main inconveniences of BAC as it does not cause intracranial flow disruption, it may be a valid alternative in very tortuous anatomies and provides a permanent support over the aneurysm neck that will prevent migration of the coil mesh at all times. In contrast, it involves the need for additional drugs (dual antiplatelet therapy), which makes its use controversial in the case of ruptured aneurysms [ 16 , 17 ]. The same problem occurs in the treatment with flow diverter stents, since, as in the case of SAC, the use of permanent antiplatelet therapy is mandatory [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Comaneci device-assisted embolization of wide-necked carotid aneurysms with an unfavorable ratio

et al. 2020

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Background Endovascular treatment is the technique of choice for most intracranial aneurysms. However, the treatment of morphologically complex wide-necked aneurysms with an unfavorable anatomy is still a therapeutic challenge. The purpose of the study is to describe the initial experience with the Comaneci embolization assist device for the treatment of wide-necked aneurysms with an unfavorable ratio for direct embolization. Methods We report a retrospective single-center analysis taken from a prospective database of consecutive aneurysms of the anterior circulation treated using the Comaneci device in the period from March 2017 to March 2019. Results Eighteen aneurysms were collected from 16 patients (9 women and 7 men) treated using the Comaneci device. The mean age was 48.4 years (range 36–81). Twelve patients had SAH, three were incidental aneurysms and one had compressive symptoms. A complete asymptomatic occlusion rate of 88.8% was obtained. The major complication rate was 5.55%. Conclusion The Comaneci embolization assist device is a safe, effective option for endovascular treatment of complex aneurysms with an unfavorable ratio.

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“…Embolization therapy has been proven to be a critical strategy for managing patients suffering from cardiovascular diseases and surgical bleeding (10,11). In the last decade, embolization therapy has been widely used in the treatment of post-operative bleeding and delayed PPH caused by pseudoaneurysm (12); however, these pseudoaneurysms are managed by exploration in patients with hemodynamically stable conditions.…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of coil embolization in treating pseudoaneurysm post‑Whipple operation

Cong

Zhou

et al. 2020

Exp Ther Med

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The present study aimed to evaluate the clinical efficacy and safety of angiography and coil embolization for pseudoaneurysm post-pancreatoduodenectomy (PD). A total of 17 patients with gastrointestinal or abdominal hemorrhage after PD were included in the present study. Angiography was performed on the celiac artery, common hepatic artery, splenic artery, gastroduodenal artery and superior mesenteric artery to determine the size of the pseudoaneurysm, the parent artery and its collateral branches. A variety of embolization techniques have been applied to embolize pseudoaneurysm, including the sac packing technique, proximal embolization, exclusion technique and sandwich technique. Different techniques with coils were used for embolization and the clinical effects of embolization were analyzed. A total of 18 pseudoaneurysms were identified in 17 patients. In 2 patients, severe technical complications occurred, including migration of the coil and rupture of pseudoaneurysm, and one of them died, which may have been associated with this complication. No serious clinical complications were observed in the other patients. A total of 7 patients had mild clinical complications, including mild abdominal and dorsal pain, which were alleviated after symptomatic management. A total of 15 patients with definite pseudoaneurysm were successfully embolized without re-bleeding and complications. The clinical success rate was 94.1% (16/17). In conclusion, a variety of embolization techniques may be applied for the treatment of pseudoaneurysm after PD, which have high technical and clinical success rates and small trauma. It is recommended in emergency situations, but care should be taken to avoid serious technical complications.

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Clinical Study on Complications of Intracranial Ruptured Aneurysm Embolization by Stent-Assisted Coil

Cited by 10 publications

References 17 publications

The SMART Registry: Long-Term Results on the Utility of the Penumbra SMART COIL System for Treatment of Intracranial Aneurysms and Other Malformations

The SMART Registry: Long-Term Results on the Utility of the Penumbra SMART COIL System for Treatment of Intracranial Aneurysms and Other Malformations

Comaneci device-assisted embolization of wide-necked carotid aneurysms with an unfavorable ratio

Clinical efficacy of coil embolization in treating pseudoaneurysm post‑Whipple operation

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