Stent‐Assisted Coiling Versus Balloon‐Assisted Coiling for the Treatment of Ruptured Wide‐Necked Aneurysms: A 2‐Center Experience

Vivanco‐Suarez, Juan; Wallace, Adam N.; Dandapat, Sudeepta; Lopez, Gloria V.; Mendez‐Ruiz, Aldo; Kayan, Yasha; Copelan, Alexander; Dajles, Andres; Zevallos, Cynthia; Quispe‐Orozco, Darko; Mendez‐Ruiz, Alan; Galecio‐Castillo, Milagros; Samaniego, Edgar A; Farooqui, Mudassir; Delgado, Josser; Ortega‐Gutiérrez, Santiago

doi:10.1161/svin.122.000456

Cited by 6 publications

(1 citation statement)

References 40 publications

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“…SAC (LVIS stent) or BAC (Scepter c) was performed for wide-necked aneurysms. 5 11 An aneurysm with a neck diameter of 4 mm or bigger or a dome-to-neck (D-N) ratio of less than 2 was regarded as a wide-necked intracranial aneurysm. 12 In the case of using BAC, we used a coaxial or triaxial system to advance the balloon and a coiling microcatheter into the affected aneurysm.…”

Section: Methodsmentioning

confidence: 99%

Endovascular Treatment of Anterior Communicating Artery Aneurysms: A Single-Center Experience from a Developing Country

Saghebdoust,

Barani,

Mehrizi

et al. 2023

Asian J Neurosurg

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Objective In recent years, endovascular methods have been developed to treat intracranial aneurysms. To date, results of endovascular treatment (EVT) for anterior communicating aneurysms (ACoAs) have never been investigated in Iran. Thus, we sought to assess the mid-term angiographic and clinical outcomes of patients with ACoAs who underwent EVT in a tertiary center. Materials and Methods Electronic health documents of patients with ACoAs who underwent EVT from March 2019 to July 2021 were retrospectively reviewed. Demographic and clinical characteristics of patients, procedural and clinical complications along with immediate and 12 months' postprocedural angiographic and clinical results were included in the analysis. Aneurysm occlusion status was classified based on the Raymond–Roy Occlusion Classification (RROC), and clinical outcomes were assessed using the modified Rankin Scale (mRS). Results Of 38 patients with 38 ACoAs, 32 patients (84.21%) presented with subarachnoid hemorrhage of whom 23 (60.52%) had ruptured ACoAs. EVT included simple coiling in 29 patients (76.32%), balloon-assisted coiling in 6 (15.79%), and stent-assisted coiling in 3 (7.89%). Immediate and 12-month postprocedural angiograms demonstrated complete/near-complete occlusion (RROC I and II) in 32 (84.21%) and 35 patients (97.22%), respectively. Periprocedural complications occurred in five patients (13.15%), and the mortality rate was 5.26%. Thirty-two patients (84.21%) had favorable outcomes (mRS 0–2) at the last follow-up. Conclusion EVT is a safe and beneficial procedure with favorable mid-term clinical and angiographic outcomes for ACoAs. Our results can lay the foundation for further studies in developing countries and are satisfactory enough for neurointerventionists to put EVT on the therapeutic agenda of ACoAs.

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Section: Methodsmentioning

confidence: 99%

Endovascular Treatment of Anterior Communicating Artery Aneurysms: A Single-Center Experience from a Developing Country

Saghebdoust,

Barani,

Mehrizi

et al. 2023

Asian J Neurosurg

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Systematic Review and Meta-Analysis of Endovascular Therapy Effectiveness for Unruptured Saccular Intracranial Aneurysms

Pineda-Castillo,

Jones,

Laurence

et al. 2023

Preprint

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Background: Currently, endovascular treatment of intracranial aneurysms (ICAs) is limited by low complete occlusion rates. The advent of novel endovascular technology has expanded the applicability of endovascular therapy; however, the superiority of novel embolic devices over the traditional Guglielmi detachable coils (GDCs) is still debated. We performed a systematic review of literature that reported the Raymond-Roy occlusion classifications (RROC) rates of modern endovascular devices to determine their immediate and long-term occlusion effectiveness for the treatment of unruptured saccular ICAs. Methods: A search was conducted using electronic databases (PUBMED, Cochrane, ClinicalTrials.gov, Web of Science). We retrieved studies published between 2000-2022 reporting immediate and long-term RROC rates of subjects treated with different endovascular ICA therapies. We extracted demographic information of the treated patients and their reported angiographic RROC rates. Results: A total of 80 studies from 15 countries were included for data extraction. RROC rates determined from angiogram were obtained for 21,331 patients (72.5% females, pooled mean age: 58.2 (95% CI: 56.8-59.6), harboring 22,791 aneurysms. The most frequent aneurysm locations were the internal carotid artery (46.4%, 95% CI: 41.9%-50.9%), the anterior communicating artery (26.4%, 95% CI: 22.5%-30.8%), the middle cerebral artery (24.5%, 95% CI:19.2%-30.8%) and the basilar tip (14.4%, 95% CI:11.3%-18.3%). The RROC rates were analyzed for GDCs, the Woven EndoBridge (WEB), and flow diverters. The immediate complete occlusion (RROC-I) rate was the highest in balloon-assisted coiling (73.9%, 95% CI: 65.0%-81.2%) and the lowest in the WEB (27.8%, 95% CI:13.2%-49.2%). The long-term complete occlusion probability was homogenous in all analyzed devices. Conclusions: We observed that the coil-based endovascular therapy provides acceptable rates of complete occlusion, where the balloon-assisted coils provide greater probability of immediate complete occlusion. Out of the analyzed devices, the WEB exhibited the shortest time to achieve >90% probability of long-term complete occlusion (~18 months). Overall, the GDCs remain the gold standard for endovascular treatment of unruptured saccular aneurysms.

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Systematic Review and Meta‐Analysis of Endovascular Therapy Effectiveness for Unruptured Saccular Intracranial Aneurysms

Pineda‐Castillo,

Jones,

Laurence

et al. 2024

SVIN

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BACKGROUND Currently, endovascular treatment of intracranial aneurysms is limited by low complete occlusion rates. The advent of novel endovascular technology has expanded the applicability of endovascular therapies; however, the superiority of novel embolic devices over the traditional Guglielmi detachable coils is still debated. We performed a systematic review of literature that reported the Raymond–Roy occlusion classification (RROC) rates of modern endovascular devices to determine their immediate and follow‐up occlusion effectivenesses for the treatment of unruptured saccular intracranial aneurysms. METHODS A search was conducted using electronic databases (PUBMED, Cochrane, ClinicalTrials.gov, and Web of Science). We retrieved studies published between 2000 and 2022, reporting immediate and follow‐up RROC rates of subjects treated with different endovascular intracranial aneurysm therapies. We extracted demographic information of the treated patients and their reported angiographic RROC rates. RESULTS A total of 80 studies from 15 countries were included for data extraction. The RROC rates determined from angiogram were obtained for 21 331 patients (72.5% women, pooled mean age: 58.2 [95% CI]: 56.8–59.6), harboring 22 791 aneurysms. The most frequent aneurysm locations were the internal carotid artery (46.4%, 95% CI: 41.9%–50.9%), the anterior communicating artery (26.4%, 95% CI: 22.5%–30.8%), the middle cerebral artery (24.5%, 95% CI: 19.2%–30.8%), and the basilar tip (14.4%, 95% CI: 11.3%–18.3%). The complete occlusion probability (RROC‐I) was analyzed for Guglielmi detachable coils, the Woven EndoBridge, and flow diverters. The RROC‐I rate was the highest in balloon‐assisted coiling (73.9%, 95% CI: 65.0%–81.2%) and the lowest in the Woven EndoBridge (27.8%, 95% CI: 13.2%–49.2%). The follow‐up RROC‐I probability was homogenous in all analyzed devices. CONCLUSION We observed that the coil‐based endovascular therapy provides acceptable rates of complete occlusion, and these rates are improved in balloon‐assisted coils. Out of the analyzed devices, the Woven EndoBridge exhibited the shortest time to achieve >90% probability of follow‐up complete occlusion (∼18 months). Overall, the Guglielmi detachable coils remain the gold standard for endovascular treatment of unruptured saccular aneurysms.

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Stent‐Assisted Coiling Versus Balloon‐Assisted Coiling for the Treatment of Ruptured Wide‐Necked Aneurysms: A 2‐Center Experience

Cited by 6 publications

References 40 publications

Endovascular Treatment of Anterior Communicating Artery Aneurysms: A Single-Center Experience from a Developing Country

Endovascular Treatment of Anterior Communicating Artery Aneurysms: A Single-Center Experience from a Developing Country

Systematic Review and Meta-Analysis of Endovascular Therapy Effectiveness for Unruptured Saccular Intracranial Aneurysms

Systematic Review and Meta‐Analysis of Endovascular Therapy Effectiveness for Unruptured Saccular Intracranial Aneurysms

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