title: Comparison of Stent-Assisted Coiling vs Coiling Alone in 563 Intracranial Aneurysms: Safety and Efficacy at a High-Volume Center.
abstract: BACKGROUND
  Stent-assisted coiling has been used in both unruptured and ruptured aneurysms, but the safety and efficacy still remain controversial.
  
  
  OBJECTIVE
  To compare the safety and efficacy of stent-assisted coiling with coiling alone for intracranial aneurysms.
  
  
  METHODS
  We retrospectively reviewed 512 patients treated by endovascular coiling or stent-assisted coiling over a 1-year period. The patients' clinical and imaging information was recorded. Procedure-related complication rates, recurrence rates, and clinical outcomes were analyzed in both the total aneurysms and the subgroups of ruptured and unruptured aneurysms.
  
  
  RESULTS
  A total of 243 patients were treated by coiling alone and 269 patients were treated by stent-assisted coiling. Procedure-related complications occurred in 6.2% of patients in the coiling-alone group compared with 6.3% in the stent-assisted coiling group. The procedural permanent morbidity and mortality rates were 1.6% (4/243) and 1.2% (3/243), respectively, in the coiling-alone group and 1.1% (3/269) and 1.5% (4/269), respectively, in the stent-assisted coiling group. A significantly lower recurrence rate was found in the stent-assisted coiling group compared with the coiling-alone group (5.2% vs 16.5%, P = .002). In a comparison of subgroups of ruptured and unruptured aneurysms, the procedural complications rates were comparable in the 2 groups, with a lower recurrence rate in the stent-assisted coiling group. Multivariate analysis showed that larger aneurysm size and higher Hunt and Hess grade were predictors of procedural morbidity; larger aneurysm size, ruptured aneurysm, anterior circulation aneurysms, initial incomplete occlusion, and lack of stent assistance were predictors of recurrence.
  
  
  CONCLUSIONS
  Compared with coiling alone, stent-assisted coiling may achieve lower recurrence rates, with comparable procedure-related complications and clinical outcomes in both ruptured and unruptured aneurysms.
authors: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors: Hongchao
authors: H
authors: Yang
authors: Yong
authors: Y
authors: Sun
authors: Yuhua
authors: Y
authors: Jiang
authors: Xianli
authors: X
authors: Lv
authors: Yang
authors: Y
authors: Zhao
authors: Youxiang
authors: Y
authors: Li
authors: Aihua
authors: A
authors: Liu
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000601:surgery; D002533:Cerebral Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D012449:Safety; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome