Safety and Efficacy of Stent-Assisted Coiling of Unruptured Intracranial Aneurysms Using Low-Profile Stents in Small Parent Arteries

J. Kim; H.J. Han; W. Lee; S.K. Park; J. Chung; Y.B. Kim; K.Y. Park

doi:10.3174/ajnr.A7196

Research ArticleNeurointervention

Safety and Efficacy of Stent-Assisted Coiling of Unruptured Intracranial Aneurysms Using Low-Profile Stents in Small Parent Arteries

J. Kim, H.J. Han, W. Lee, S.K. Park, J. Chung, Y.B. Kim and K.Y. Park

American Journal of Neuroradiology September 2021, 42 (9) 1621-1626; DOI: https://doi.org/10.3174/ajnr.A7196

J. Kim

aFrom the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.)

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H.J. Han

aFrom the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.)

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W. Lee

bSeverance Stroke Center, and Department of Neurosurgery (W.L., S.K.P.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

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S.K. Park

bSeverance Stroke Center, and Department of Neurosurgery (W.L., S.K.P.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

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J. Chung

aFrom the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.)

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Y.B. Kim

aFrom the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.)

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K.Y. Park

aFrom the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.)

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Table 1:

Details of endovascular procedures

Variables	Values
Platelet function test
PRU (SD)	187.7 (67.1)
Clopidogrel hyporesponder (No.) (%)	23 (34.8)^{^a}
Stent type (No.) (%)
LVIS Jr	22 (33.3)
Neuroform Atlas	44 (66.7)
No. of stents (No.) (%)
1	59 (89.4)
2	7 (10.6)^{^b}

↵a Modified with cilostazol (100 mg twice daily).
↵b Including 6 Y-stent placements.

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Table 2:

Procedure-related complications and 90-day clinical outcomes

Clinical Outcomes	Values
Procedure-related complications (No.) (%)	10 (15.2)
Thromboembolism	8 (12.1)^{^a}
Hemorrhage	2 (3.0)
Unfavorable outcome (mRS ≥3) (No.) (%)	3 (4.5)
Procedure-related mortality (No.) (%)	0

↵a Including 7 asymptomatic cases.

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Table 3:

Radiologic outcomes

Aneurysm Occlusion Classification	Values
Immediate postprocedural (No.) (%)
RR I	38 (57.6)
RR II	13 (19.7)
RR III	15 (22.7)
Follow-up occlusion (median, 12.1 mo) (No.) (%)
RR I	51 (87.9)
RR II	4 (6.9)
RR III	3 (5.2)
Recurrence (No.) (%)	2 (3.4%)^{^a}
In-stent stenosis (No.) (%)	0 (0%)

↵a Neither of these patients required retreatment.

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Table 4:

Multivariate analysis of risk factors for procedure-related complications

Variables	Odds Ratio	95% Wald CI	P Value
Age	1.08	0.99–1.19	.086
Female sex	5.38	0.61–47.72	.131
Current smoking	7.10	1.35–37.50	.021^{^a}
Diabetes mellitus	3.25	0.15–72.60	.457
Cardiovascular disease	2.24	0.15–33.63	.560
Parent artery diameter	18.40	0.126–2694.60	.252
RR I	2.30	0.23–22.94	.478

↵a Statistically significant.

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J. Kim, H.J. Han, W. Lee, S.K. Park, J. Chung, Y.B. Kim, K.Y. Park

Safety and Efficacy of Stent-Assisted Coiling of Unruptured Intracranial Aneurysms Using Low-Profile Stents in Small Parent Arteries

American Journal of Neuroradiology Sep 2021, 42 (9) 1621-1626; DOI: 10.3174/ajnr.A7196

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Safety and Efficacy of Stent-Assisted Coiling of Unruptured Intracranial Aneurysms Using Low-Profile Stents in Small Parent Arteries

J. Kim, H.J. Han, W. Lee, S.K. Park, J. Chung, Y.B. Kim, K.Y. Park

American Journal of Neuroradiology Sep 2021, 42 (9) 1621-1626; DOI: 10.3174/ajnr.A7196

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