title: Aneurysm ostium angle: a predictor of the need for stent as assistance for endovascular aneurysm coiling in internal carotid artery sidewall aneurysms.
abstract: OBJECTIVE
  There is no satisfactory parameter that can predict the need for assistant devices for endovascular aneurysm coiling. Our aim was to evaluate the utility of MOA as a predictor of the need for stent-assisted coiling in ICA sidewall aneurysms.
  
  
  METHODS
  From a retrospective review of an internal data base, 55 consecutive ICA sidewall aneurysms were identified. Thirty-two of the aneurysms were treated by using endovascular techniques. Because 23 of the 55 aneurysms were either untreated or clipped, 3 experienced interventionalists reviewed the 3D images of these aneurysms and then made a decision as to whether stent-assisted coiling would have been required. Thirty-one of the 55 aneurysms would have required stent-assisted coiling, while 24 would not. Neck width, DNR, AR, and MOA were obtained from each aneurysm by using prototype software. These parameters were then correlated with the requirement of stent-assisted coiling.
  
  
  RESULTS
  MOA and neck width of aneurysms requiring stent-assisted coiling were significantly larger than those not requiring stent-assisted coiling (P < .001 and <0.001, respectively). Although the DNR and AR of aneurysms requiring stent-assisted coiling were smaller than those not requiring it, the difference was not significant (P = .22 and 0.12, respectively). ROC analysis revealed that MOA was the parameter that best correlated with the need for stent-assisted coiling. Inclusion of MOA with the rest of the parameters significantly increased the predictive performance regarding the need for stent-assisted coiling (P = .005).
  
  
  CONCLUSIONS
  In this small study, MOA was a useful parameter to predict the need for stent-assisted coiling in ICA sidewall aneurysms. Further prospective study of this parameter for aneurysms at multiple locations is required to determine its ultimate value.
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
authors.forename: R
authors.initials: R
authors.lastname: Yasuda
authors.forename: A
authors.initials: A
authors.lastname: Arat
authors.forename: C M
authors.initials: CM
authors.lastname: Strother
authors.forename: B
authors.initials: B
authors.lastname: Aagaard-Kienitz
authors.forename: D
authors.initials: D
authors.lastname: Niemann
authors.forename: A
authors.initials: A
authors.lastname: Mohamed
authors.forename: K
authors.initials: K
authors.lastname: Royalty
authors.forename: K
authors.initials: K
authors.lastname: Pulfer
authors.forename: W
authors.initials: W
authors.lastname: Taki
authors.forename: M E
authors.initials: ME
authors.lastname: Mawad
mesh_terms: D000328:Adult; D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging* / Q000628:therapy*; D002533:Cerebral Angiography; D015331:Cohort Studies; D016208:Databases, Factual; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015607:Stents