title: Stent-assisted coiling versus coiling alone of ruptured anterior communicating artery aneurysms: A single-center experience.
abstract: OBJECTIVE
  Endovascular coiling of anterior communicating artery (ACoA) aneurysms has evolved; however, stent-assisted coiling of ruptured aneurysms remains controversial. We aimed to compare periprocedural complications, angiographic and clinical outcomes after stent-assisted coiling with coiling alone of ruptured ACoA aneurysms.
  
  
  METHODS
  We performed a retrospective review of consecutive 222 patients with ruptured ACoA aneurysms treated with endovascular coiling within 7 days after ictus. Patients were grouped into stent-assisted coiling and coiling alone groups. Baseline characteristics, periprocedural complications, clinical outcomes, and angiographic results were compared between the two groups.
  
  
  RESULTS
  63 (28.4%) patients underwent stent-assisted coiling and 159 (71.6%) underwent coiling alone. There were no statistically significant differences in age, sex, clinical grading and Fisher grade. Larger aneurysms (P=0.002) and wider-neck aneurysms (P<0.001) were more often treated with stent-assisted coiling within 72h (P=0.025). Intraprocedural aneurysm rupture occurred in 6 (9.5%) patients treated with stent-assisted coiling compared with in 5 (3.1%) treated with coiling alone (P<0.048). Thrombus formation occurred in 10 (15.9%) patients after stent-assisted coiling compared with 6 (3.8%) after coiling alone (P=0.002). Stent-assisted coiling achieved a lower rate of immediate occlusion than coiling alone (P=0.045). Postoperative complications, clinical outcomes, and follow-up aneurysm occlusion did not significantly differ.
  
  
  CONCLUSIONS
  Stent-assisted coiling of ruptured ACoA aneurysms was associated with a higher rate of intraprocedural complications and associated with a lower immediate occlusion rate. However, Postoperative complications and clinical outcomes did not differ. Long-term angiographic results require further study.
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Lianghao
authors.initials: L
authors.lastname: Fan
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Xianxi
authors.initials: X
authors.lastname: Tan
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Kuang
authors.initials: K
authors.lastname: Zheng
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Zequn
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, the Second Renmin Hospital of Taizhou, Taizhou, China.
authors.forename: Dajun
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhong
authors.affiliation: Department of Neurosurgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA. Electronic address: drzhaobing@yahoo.com.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000628:therapy*; D057510:Endovascular Procedures / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D012189:Retrospective Studies; D015607:Stents; D055815:Young Adult
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Anterior communicating artery; Coiling; Complications; Ruptured aneurysms; Stent-assisted coiling