title: Stability of Cerebral Aneurysms After Stent-Assisted Coil Embolization: A Propensity Score-Matched Analysis.
abstract: BACKGROUND
  The availability of stents has widened the indications of endovascular intervention for cerebral aneurysms.
  
  
  OBJECTIVE
  To elucidate the effect of stents on radiologic outcomes and to analyze the risk factors for aneurysmal recanalization via propensity score matching.
  
  
  METHODS
  From the 735 aneurysms treated with coil embolization with stents (n = 187) and without stents (n = 548) between 2009 and 2011, 157 propensity score-matched case pairs were selected. The recanalization rates and relevant risk factors were analyzed. The mean follow-up interval was 24.1 ± 11.3 months (range, 6-48 months) and 22.9 ± 11.4 months (range, 6-56 months) in the stent and nonstent groups, respectively (P = .388).
  
  
  RESULTS
  The stent group demonstrated lower recanalization rates than the nonstent group during both the 6-month (1.9% vs 10.2%, P = .004) and the final follow-up periods (8.3% vs 18.5%, P = .005). The multivariate analysis identified the following significant factors for recanalization: the use of stents (hazard ratio, 0.40; 95% confidence interval, 0.21-0.76, P = .005), larger aneurysm size (hazard ratio, 1.21; 95% confidence interval, 1.11-1.31, P < .001), and initially incomplete occlusion (hazard ratio, 2.39; 95% confidence interval, 1.28-4.43, P = .006). The incidence of permanent neurological complication tended to be higher in the stent group than in the nonstent group (3.2% vs 0%, P = .063).
  
  
  CONCLUSIONS
  In this propensity score-matched analysis, stent implantation reduced the overall recanalization of the coiled cerebral aneurysms. However, the use of stents should be carefully decided upon.
authors.affiliation: *Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea; ‡Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea; §Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Won-Sang
authors.initials: WS
authors.lastname: Cho
authors.forename: Hyun Sook
authors.initials: HS
authors.lastname: Hong
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Kang
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Cho
authors.forename: O-Ki
authors.initials: OK
authors.lastname: Kwon
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Bang
authors.forename: Gyojun
authors.initials: G
authors.lastname: Hwang
authors.forename: Young Je
authors.initials: YJ
authors.lastname: Son
authors.forename: Chang Wan
authors.initials: CW
authors.lastname: Oh
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D057216:Propensity Score; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult