Stent-assisted coiling of paraclinoid aneurysms: risks and effectiveness

Area of Science:

• Interventional Neuroradiology
• Cerebrovascular Surgery
• Neurosurgical Endovascular Therapy

Background:

• Stent assistance is increasingly adopted for treating wide-based aneurysms.
• Paraclinoid aneurysms present unique challenges in endovascular treatment.

Observation:

• A retrospective analysis compared stent-assisted coiling (70 aneurysms) with coiling alone (24 aneurysms) for paraclinoid internal carotid artery aneurysms.
• Stent-assisted coiling demonstrated high occlusion rates (60% at completion, 66.7% at follow-up) comparable to coiling alone (54.2% at completion, 75% at follow-up).

Findings:

• Stent-assisted coiling showed comparable effectiveness and safety to coiling alone for paraclinoid aneurysms.
• Complications included transient thrombus and stent displacement, with minimal neurologic sequelae.
• Excellent/good outcomes were achieved in 91.9% of stent-assisted coiling patients versus 95.8% of coiling-alone patients.

Implications:

• Stent-assisted coiling is a safe and effective adjunct for treating complex paraclinoid aneurysms.
• Further validation through prospective controlled trials is warranted to confirm these findings.
• This approach expands endovascular treatment options for challenging aneurysm locations.