Coiling Variations for Treatment of Ruptured Intracranial Aneurysms: A Meta-Analytical Comparison of Comaneci-, Stent-, and Balloon-Coiling Assistance Techniques

Lim, Jaims; Monteiro, Andre; Jacoby, Wady T.; Danziger, Hannah; Kuo, Cathleen C.; Alkhars, Hussain; Donnelly, Brianna M.; Khawar, Wasiq I.; Lian, Ming X.; Iskander, Joseph; Davies, Jason M.; Snyder, Kenneth V.; Siddiqui, Adnan H.; Levy, Elad I.

doi:10.1016/j.wneu.2023.05.008

Cited by 6 publications

(2 citation statements)

References 80 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…35–37 However, according to the STAT trial (Stent-Assisted Coiling in the Treatment of Unruptured Intracranial Aneurysms), stent-assisted coiling was not superior to coiling alone in terms of functional and angiographic outcomes when used in the treatment of large, wide-neck, or recurrent unruptured aneurysms. 38 Balloon-assisted coiling has similar results with complete occlusion rates at the end of the treatment comparable to stent-assisted coiling in a large systematic review and meta-analysis by Wang et al 39–42 Stented patients had higher progressive aneurysm occlusion at 6-month follow-up (odds ratio, 1.82 [95% CI, 1.21–2.74]) compared with balloon patients.…”

Section: Endovascularmentioning

confidence: 94%

ARISE I Consensus Review on the Management of Intracranial Aneurysms

Tjoumakaris,

Hanel,

Mocco

et al. 2024

Stroke

View full text Add to dashboard Cite

BACKGROUND: Intracranial aneurysms (IAs) remain a challenging neurological diagnosis associated with significant morbidity and mortality. There is a plethora of microsurgical and endovascular techniques for the treatment of both ruptured and unruptured aneurysms. There is no definitive consensus as to the best treatment option for this cerebrovascular pathology. The Aneurysm, Arteriovenous Malformation, and Chronic Subdural Hematoma Roundtable Discussion With Industry and Stroke Experts discussed best practices and the most promising approaches to improve the management of brain aneurysms. METHODS: A group of experts from academia, industry, and federal regulators convened to discuss updated clinical trials, scientific research on preclinical system models, management options, screening and monitoring, and promising novel device technologies, aiming to improve the outcomes of patients with IA. RESULTS: Aneurysm, Arteriovenous Malformation, and Chronic Subdural Hematoma Roundtable Discussion With Industry and Stroke Experts suggested the incorporation of artificial intelligence to capture sequential aneurysm growth, identify predictors of rupture, and predict the risk of rupture to guide treatment options. The consensus strongly recommended nationwide systemic data collection of unruptured IA radiographic images for the analysis and development of machine learning algorithms for rupture risk. The consensus supported centers of excellence for preclinical multicenter trials in areas such as genetics, cellular composition, and radiogenomics. Optical coherence tomography and magnetic resonance imaging contrast–enhanced 3T vessel wall imaging are promising technologies; however, more data are needed to define their role in IA management. Ruptured aneurysms are best managed at large volume centers, which should include comprehensive patient management with expertise in microsurgery, endovascular surgery, neurology, and neurocritical care. CONCLUSIONS: Clinical and preclinical studies and scientific research on IA should engage high-volume centers and be conducted in multicenter collaborative efforts. The future of IA diagnosis and monitoring could be enhanced by the incorporation of artificial intelligence and national radiographic and biologic registries. A collaborative effort between academic centers, government regulators, and the device industry is paramount for the adequate management of IA and the advancement of the field.

show abstract

Section: Endovascularmentioning

confidence: 94%

ARISE I Consensus Review on the Management of Intracranial Aneurysms

Tjoumakaris,

Hanel,

Mocco

et al. 2024

Stroke

View full text Add to dashboard Cite

show abstract

“… 42) A recent meta-analysis of treatments for acute subarachnoid hemorrhage from wide-necked aneurysms showed favorable embolization rates and safety compared to BAC or SAC. 43) Appropriate antiplatelet therapy and intravenous heparin administration are important to prevent thrombus formation inside the mesh of the Comaneci. 44) Treatment options in combination with BAC or SAC may be selected for difficult-to-treat WNBAs.…”

Section: Other Stenting Techniquesmentioning

confidence: 99%

Endovascular Treatment of Wide-Neck Bifurcation Aneurysm: Recent Trends in Coil Embolization with Adjunctive Technique

Haryu,

Sakata,

Matsumoto

et al. 2024

JNET

View full text Add to dashboard Cite

Wide-neck bifurcation aneurysms (WNBAs) are sometimes challenging to treat. During endovascular treatment, it is important to prevent coil deviation and preserve normal vessels. Adjunctive balloon- and stent-assisted techniques have been developed. A meta-analysis of endovascular treatments of WNBAs revealed that only 40% of patients had complete occlusion. Recently, novel devices have been developed to expand the range of treatment options. Flow-diverter stents and intra-aneurysmal flow disruption devices do not require coils; however, coil embolization remains the standard procedure used by many neurointerventionists. This review describes the recent trends in adjunctive techniques for supporting coil embolization for WNBAs. We referred to literature on balloon-assisted techniques, stent-assisted techniques, Y-stenting, PulseRider, Barrel stents, Comaneci temporary stents, pCONUS, and eCLIPs. These reports showed that adequate embolization rates were generally greater than 80%, and the complete occlusion rate was as high as 94.6%. All devices had a relatively high occlusion rate; however, it may be inaccurate to simply compare each device because of the heterogeneity of the studies. It is important to select the best treatment for each individual case by considering not only literature-based efficacy and safety but also patient background, aneurysm characteristics, and operator experience.

show abstract

Mid-term outcomes in stent-assisted coil embolization for ruptured cerebral aneurysms in the acute period: A single institution retrospective review

Lui,

Ng,

et al. 2024

Brain Hemorrhages

View full text Add to dashboard Cite

Coiling Variations for Treatment of Ruptured Intracranial Aneurysms: A Meta-Analytical Comparison of Comaneci-, Stent-, and Balloon-Coiling Assistance Techniques

Cited by 6 publications

References 80 publications

ARISE I Consensus Review on the Management of Intracranial Aneurysms

ARISE I Consensus Review on the Management of Intracranial Aneurysms

Endovascular Treatment of Wide-Neck Bifurcation Aneurysm: Recent Trends in Coil Embolization with Adjunctive Technique

Mid-term outcomes in stent-assisted coil embolization for ruptured cerebral aneurysms in the acute period: A single institution retrospective review

Contact Info

Product

Resources

About