title: Stent-Assisted Coiling May Prevent the Recurrence of Very Small Ruptured Intracranial Aneurysms: A Multicenter Study.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of endovascular treatments, including stent-assisted coiling, of very small (≤3 mm), ruptured intracranial aneurysms.
  
  
  METHODS
  Ninety-three endovascularly treated patients with very small ruptured aneurysms were recruited from 4 high-volume centers between September 2010 and February 2014. Factors influencing procedural complications and outcomes were analyzed.
  
  
  RESULTS
  Fifty-one (54.8%) aneurysms were treated by stent-assisted coiling, 41 (44.1%) by coiling alone, and 1 (1.1%) by balloon-assisted coiling. Intraprocedural or postprocedural complications occurred in 13 patients (14.0%): coil migration in 1, intraprocedural rupture in 1, hydrocephalus in 6, and ischemic event in 1. No tested factor was able to predict procedural complications. Angiographic follow-up of 67 aneurysms (72%) revealed recurrence in 5 patients (7.5%). One recurrent case was treated initially by stent-assisted coiling and the remaining four by coiling alone (P = 0.044). Multivariate regression analysis showed that coiling alone was significantly associated with aneurysm recurrence (odds ratio, 13.8; 95% confidence interval, 1.1-175.3; P = 0.043).
  
  
  CONCLUSIONS
  Endovascular treatment of very small ruptured aneurysms was safe and effective and was not associated with a high rate of intraprocedural rupture. Treatment with the use of stents significantly lowered the recurrence rate without additional risks.
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yisen
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Wuhan General Hospital, Guangzhou Military Command of PLA, Wuhan, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, XuanWu Hospital, Capital Medical University, Beijing, China.
authors.forename: Hongqi
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Huashan Hospital Affiliated to Fudan University, Shanghai, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Youxiang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Chuhan
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China. Electronic address: jianliu_ns@163.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China. Electronic address: yang-xj@163.net.
authors.forename: Xinjian
authors.initials: X
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012008:Recurrence; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult
keywords: Endovascular treatment; Intracranial aneurysms; Multicenter study; Ruptured