title: Results of stent-assisted vs non-stent-assisted endovascular therapies in 489 cerebral aneurysms: single-center experience.
abstract: BACKGROUND
  Whether the addition of stenting to intracranial aneurysm coil embolization results in benefit in terms of occlusion rates or additional risk in terms of periprocedural adverse events is not clear.
  
  
  OBJECTIVE
  To report retrospectively analyzed results of endovascular aneurysm treatment comparing stent-assisted coiling with coiling without stents at our hospital from 2005 to 2009.
  
  
  METHODS
  In this retrospectively reviewed case series, aneurysms were grouped as intent-to-treat or initially treated with stent-assisted coiling (A) vs coiling alone (B) or as-treated-those that ultimately received a stent (C) or not (D). Complication and occlusion rates were compared between groups. Some patients crossed from group B to C after receiving stent placement at a later treatment following the initial therapeutic modality (without a stent).
  
  
  RESULTS
  In 459 patients, 489 aneurysms were treated by group as follows: A = 181, B = 308, C = 225, and D = 264. In stent groups (A and C), there were significantly lower frequencies of ruptured aneurysms (A vs B = 11% vs 62%, P < .001; C vs D = 20.4% vs 62.5%, P < .001) and more giant aneurysms (A vs B = 7.3% vs 1.0%, P = .001; C vs D = 5.9% vs 1.1%, P < .001). There was no statistically significant difference in permanent event-related morbidity (A vs B = 4.4% vs 4.2%, P = 1.0; C vs D = 4.4% vs 4.2%, P = 1.0). Average angiographic follow-up after last treatment was 18.2 ± 15 months (median = 14). Higher rates of complete occlusion at last angiographic follow-up were observed in stented aneurysms (A vs B = 64.6% vs 49.7%, P = .001; C vs D = 62.7% vs 48.9%, P = .003).
  
  
  CONCLUSIONS
  Stent-assisted aneurysm treatment resulted in higher total occlusion rates than non-stent-assisted treatment, with acceptable, comparable periprocedural event rates.
authors.affiliation: Department of Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York, USA.
authors.forename: Shady
authors.initials: S
authors.lastname: Jahshan
authors.forename: Adib A
authors.initials: AA
authors.lastname: Abla
authors.forename: Sabareesh K
authors.initials: SK
authors.lastname: Natarajan
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Drummond
authors.forename: Peter
authors.initials: P
authors.lastname: Kan
authors.forename: Yuval
authors.initials: Y
authors.lastname: Karmon
authors.forename: Kenneth V
authors.initials: KV
authors.lastname: Snyder
authors.forename: L Nelson
authors.initials: LN
authors.lastname: Hopkins
authors.forename: Adnan H
authors.initials: AH
authors.lastname: Siddiqui
authors.forename: Elad I
authors.initials: EI
authors.lastname: Levy
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D015607:Stents; D016896:Treatment Outcome