title: Clinical and angiographic outcomes of stent-assisted coiling of intracranial aneurysms.
abstract: BACKGROUND
  Despite the increasing use of stent-assisted coiling (SAC), data on its long-term clinical and angiographic results are limited.
  
  
  OBJECTIVE
  The objective of this article is to assess the long-term clinical and angiographic outcomes in SAC in our single-center practice.
  
  
  METHODS
  We conducted a retrospective analysis of intracranial aneurysms treated with detachable coils during the period 2003-2012. Patients were divided into SAC and non-SAC groups and were analyzed for aneurysm occlusion, major recurrence and clinical outcome. Logistic regression analyses identified factors associated with clinical/angiographic outcomes (p value <0.05 was statistically significant).
  
  
  RESULTS
  A total of 516 procedures met inclusion criteria: Sixty-three (12.2%) patients underwent SAC, of whom 56 (89%) had an elective procedure whereas 286 (63.1%) aneurysms from the non-SAC group were ruptured. In the unruptured subcohort, baseline class I was achieved in 24 (38%, p = 0.91), and predischarge modified Rankin scale score (mRS) 0-2 was obtained in 96.4% of cases in the SAC group versus 90.4% in the non-stent group. The major recurrence was 9.5% versus 11.3% in the SAC and non-SAC group, respectively (p = 0.003). At last clinical assessment, 98.2% of the patients from the unruptured SAC group had mRS 0-2 (mean follow-up, 58 months) versus 93.6% (mean follow-up, 56 months) in the unruptured non-SAC group (p = 0.64). Periprocedural vasospasm was associated with long-term poor outcome in the unruptured SAC subcohort (p = 0.0008).
  
  
  CONCLUSIONS
  SAC and non-SCA techniques show comparable safety and clinical outcome. The SAC technique significantly decreases retreatment rates. Periprocedural vasospasm resulting from vessel manipulation is associated with poor outcome in SAC of unruptured aneurysms.
authors.affiliation: Department of Neurosurgery, The Ottawa Hospital, University of Ottawa, Canada.
authors.forename: Diana
authors.initials: D
authors.lastname: Ghinda
authors.affiliation: Neuroradiology Section, Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Canada; Ottawa Hospital Research Institute, Canada msantos@toh.on.ca.
authors.forename: Marlise Peruzzo
authors.initials: MP
authors.lastname: Dos Santos
authors.affiliation: Department of Medical Imaging, University of Ottawa, Canada.
authors.forename: Armin
authors.initials: A
authors.lastname: Sabri
authors.affiliation: Neuroradiology Section, Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Canada; Ottawa Hospital Research Institute, Canada.
authors.forename: Daniela
authors.initials: D
authors.lastname: Iancu
authors.affiliation: Neuroradiology Section, Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Canada; Ottawa Hospital Research Institute, Canada.
authors.forename: Cheemun
authors.initials: C
authors.lastname: Lum
authors.affiliation: Department of Neurosurgery, The Ottawa Hospital, University of Ottawa, Canada.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Lesiuk
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000150:complications
keywords: Intracranial aneurysm; aneurysm; clinical outcome; endovascular treatment; outcome; recanalization; recurrence; stent-assisted coiling; vasospasm