title: Use of stent-assisted coil embolization for the treatment of wide-necked aneurysms: A systematic review.
abstract: BACKGROUND
  The use of stent-assisted coiling (SAC) has been shown to be a treatment option for complex aneurysms. We reviewed systematically the immediate and mid-term angiographic results following treatment of wide-necked aneurysms with self-expanding stents and coils, as well as the peri- and postprocedural rate of complications.
  
  
  METHODS
  A computerized database search was conducted from 01/2000 to 04/2011 using appropriate indexed terms on Pubmed. Inclusion criteria were: (1) homogeneous populations of ≥10 patients with wide-necked aneurysms; (2) use of a self-expandable neurovascular stent and coils for aneurysm treatment; (3) immediate and follow-up angiographic results; and (4) periprocedural and delayed thrombotic complications.
  
  
  RESULTS
  Seventeen studies were included, containing retrospectively collected data on 656 patients/702 aneurysms. The target aneurysm was located on the anterior circulation in 78.4% of patients. The immediate rate of complete occlusion was 46.3%, (19.3-98.1%). The intra- and postprocedural rate of intrastent thrombosis or thromboembolic event was 4.6% and 4.3%, respectively. Complete occlusion was documented in 71.9% at last angiographic follow-up. The rate of recanalization was 13.2% of aneurysms (0-28.8%). Delayed in-stent stenosis occurred in 5.3% cases (0-20.6%).
  
  
  CONCLUSIONS
  SAC has been considered a treatment option for selected wide-necked aneurysms in some institutions. The use of intracranial stents should take into consideration the risk of ischemic complications, recanalization, delayed in-stent stenosis; and the currently unknown lifetime risks for stenosis, vascular injury, device failure, and aneurysm recurrence related to intracranial stenting. There is an evident need for a prospective multicenter registry for all treated patients with SAC.
authors.affiliation: Department of Neurosurgery, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 6236, Los Angeles, CA, 90095-7436, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: McLaughlin
authors.forename: David L
authors.initials: DL
authors.lastname: McArthur
authors.forename: Neil A
authors.initials: NA
authors.lastname: Martin
keywords: Aneurysm occlusion; complication; intracranial aneurysm; intracranial stent; wide neck aneurysm