title: Stent-assisted coiling in ruptured cerebral aneurysms: multi-center experience in acute phase.
abstract: BACKGROUND
  The purpose of this study is to report on a multi-center experience of ruptured intracranial aneurysms treated in acute phase with stent-assisted coil embolization, including primary success rates and midterm follow-up results.
  
  
  METHODS
  Retrospective analysis was performed on a sample of 40 patients (14 men, 26 women, mean age 59.7 years) affected by ruptured saccular aneurysms and treated by stent-assisted coiling in acute phase; double antiplatelet therapy with clopidogrel bisulphate and acetylsalicylic acid was started after the procedure. Angiographic follow-up at 1 year was recorded.
  
  
  RESULTS
  20 % of the aneurysms were located in the posterior circulation, and 85 % presented a wide neck. Mean size of the sac was 7 mm (range 3-22 mm). Complete sac exclusion was obtained in 92.5 % and neck remnant in 7.5 %. The overall complications rate was 15 %. In 7.5 %, stent occlusion occurred intra-procedurally. In 12.5 %, re-bleeding was detected within 3 weeks after the procedure. Ischemic area related to the procedure was observed at follow-up in 7.5 %. Hydrocephalus developed in 15 %. 7.5 % presented with sac re-bleeding between 1 and 5 months after the procedure. In 15 %, the 3-6 months of follow-up revealed aneurysm refilling. 25 % of the patients presented vessel stenosis at the 1-year DSA of control. 33 % of the patients reported sensory-motor deficits. 82.5 % had a favorable outcome (GOS: IV-V), while 17.5 % presented a poor score (GOS: I-III).
  
  
  CONCLUSIONS
  Stent-assisted coil embolization is a feasible endovascular treatment option for ruptured intracranial aneurysms, which is difficult to approach with simple coiling; however, neurointerventionalists need to consider a mild increase of post-procedural complications rate.
authors.affiliation: Neuroradiology Department, Cardarelli Hospital, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Muto
authors.affiliation: Radiology Department, Campus Bio-Medico University, Viale Regina Margherita 278, 00198, Rome, Italy. francescogiurazza@hotmail.it.
authors.forename: Francesco
authors.identifier: http://orcid.org/0000-0002-9080-8833
authors.initials: F
authors.lastname: Giurazza
authors.affiliation: Neuroradiology Department, Cardarelli Hospital, Naples, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Ambrosanio
authors.affiliation: Neuroradiology Department, Cardarelli Hospital, Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vassallo
authors.affiliation: Neuroradiology Department, Università Federico II di Napoli, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Briganti
authors.affiliation: Seconda Università degli studi di Napoli, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Tecame
authors.affiliation: Measurements and Biomedical Instrumentation Lab, Engineering Faculty, Campus Bio-Medico University, Rome, Italy.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Schena
authors.affiliation: Neuroradiology Department, Ospedali riuniti di Ancona, Ancona, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: De Nicola
authors.affiliation: Neuroradiology Department, Ospedali riuniti di Ancona, Ancona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sgreccia
authors.affiliation: Neuroradiology Department, Ospedali riuniti di Ancona, Ancona, Italy.
authors.forename: Mirko
authors.initials: M
authors.lastname: Giannoni
authors.affiliation: Department of Neurology and Psychiatry, Endovascular Neurosurgery/Interventional Neuroradiology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Peschillo
authors.affiliation: Department of Neurology and Psychiatry, Endovascular Neurosurgery/Interventional Neuroradiology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Diana
authors.affiliation: Department of Neurology and Psychiatry, Endovascular Neurosurgery/Interventional Neuroradiology, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Guidetti
authors.affiliation: Neuroradiology Department, Cardarelli Hospital, Naples, Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Guarnieri
mesh_terms: D000208:Acute Disease; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin
keywords: Acute; Aneurysm; Cerebral; Coiling; Ruptured; Stent