title: Single-centre comparison of procedural complications, clinical outcome, and angiographic follow-up between coiling and stent-assisted coiling for posterior communicating artery aneurysms.
abstract: Aneurysm recurrence is a principle limitation of endovascular coiling procedures, especially in posterior communicating artery aneurysms, with reported recurrence rates of >30%. The adjunctive use of self-expandable stents has revolutionised the treatment of intracranial aneurysms, especially for complex morphologies, wide necks, or unfavourable dome-to-neck ratios. However, there are limited data concerning a direct comparison between simple coiling and stent-assisted coiling in posterior communicating artery aneurysms. This study aimed to compare the durability and outcomes of coiling versus stent-assisted coiling procedures. Imaging data of patients with posterior communicating artery aneurysms treated with coiling or stent-assisted coiling between January 2008 and October 2012 were retrospectively analysed. The initial angiographic results, procedural complications, and clinical outcomes were assessed at discharge. Imaging follow-up was performed with cerebral angiography. Complete aneurysm occlusion was achieved on initial angiography in 23/56 (41.1%) stent and 83/235 (35.3%) non-stent patients. At the latest follow-up (mean follow-up 14.3 ± 10.4 months for stent and 13.2 ± 9.5 months for non-stent patients), aneurysms had recurred in 5/47 (10.6%) stent and 57/203 (28.1%) non-stent patients (p=0.014). Procedural complications occurred in 6/56 (10.7%) stent and 27/235 (11.5%) non-stent aneurysms. No rebleeding occurred during clinical follow-up (mean duration, 46.7 months). Recurrence rates at the latest follow-up were significantly lower in patients undergoing stent-assisted coiling than those undergoing simple coiling. Thus, use of the stent-assisted neck remodelling technique in the treatment of wide-necked posterior communicating artery intracranial aneurysms appears to improve the long-term clinical outcome.
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Ya-Qi
authors.initials: YQ
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China. Electronic address: doctorwang_zjyy@126.com.
authors.forename: Qiu-Jing
authors.initials: QJ
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zheng
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Xi-Feng
authors.initials: XF
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Xu-Bo
authors.initials: XB
authors.lastname: Cui
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Yu-Yuan
authors.initials: YY
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Ling-Feng
authors.initials: LF
authors.lastname: Lai
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Shi-Xing
authors.initials: SX
authors.lastname: Su
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Xu-Ying
authors.initials: XY
authors.lastname: He
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253 Industry Road, Guangzhou, Guangdong 510282, China; The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Chuan-Zhi
authors.initials: CZ
authors.lastname: Duan
mesh_terms: D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Endovascular treatment; Intracranial aneurysm; Posterior communicating artery aneurysm; Stent-assisted coiling