title: Safety and long-term efficacy of endovascular treatment of small posterior communicating artery aneurysms by coiling with or without stent: a single center retrospective study.
abstract: OBJECTIVE
  Endovascular stents have been widely used in intracranial aneurysm embolization. In this work, we compared the safety and long-term efficacy of stent-assisted coiling with those of conventional coiling for small posterior communicating artery aneurysms, aiming at a better understanding of the related safety and efficacy profiles.
  
  
  METHODS
  Between January 2008 and December 2011, 114 small PcomA aneurysms (defined as 3mm≤maximum diameter<10mm in this study) in 108 patients were treated by endovascular treatment in our department. Patient demographics, aneurysm characteristics, angiographic results (initial and follow-up), and procedural complications were assessed.
  
  
  RESULTS
  Embolization was successfully performed in all the patients. Complications occurred in 7.4% of patients in both groups. There was no associated mortality. Based on initial post-procedural angiography, the rate of complete aneurysm occlusion, neck remnant and residual sac in the stented group were 37.9%, 24.1%, and 37.9%, while in the conventional group the figures were 42.9%, 48.2%, and 8.9%, respectively. The initial angiographic results were significantly better in the conventional group, compared with the stented group (P=0.038). The follow-up results showed that the rate of improvement in the stented group was significantly higher (53.3% vs. 14.0%; P<0.001) and the recurrence rate was significantly lower than that in the conventional group (4.4% vs. 3.02%; P=0.001).
  
  
  CONCLUSIONS
  Compared with conventional coiling, stent-assisted coiling of the small posterior communicating artery aneurysms does not increase the risk. Stents bear an advantage in reducing the recurrence rate, increasing progressive occlusion rate, and improving long-term prognosis in endovascular treatment of intracranial aneurysms.
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China. Electronic address: yaopf1@163.com.
authors.forename: Peng-Fei
authors.initials: PF
authors.lastname: Yao
authors.forename: Ying
authors.initials: Y
authors.lastname: Yu
authors.forename: Peng-Fei
authors.initials: PF
authors.lastname: Yang
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
authors.forename: Bo
authors.initials: B
authors.lastname: Hong
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Zhao
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Liu
authors.forename: Qing-Hai
authors.initials: QH
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Embolization; Intracranial aneurysm; Posterior communicating artery; Stents