Stent-assisted coiling in ruptured wide-necked aneurysms: A single-center analysis

Area of Science:

• Neurosurgery
• Endovascular Surgery
• Cerebrovascular Disease

Background:

• Wide-necked intracranial aneurysms with acute subarachnoid hemorrhage (SAH) pose significant treatment challenges.
• Evaluating endovascular techniques is crucial for managing these complex cases.

Purpose of the Study:

• To assess the safety and efficacy of stent-assisted coiling for ruptured wide-necked intracranial aneurysms.
• To determine if the antiplatelet regimen can be maintained without compromising outcomes.

Main Methods:

• Retrospective study of 42 consecutive patients treated with stent-assisted coiling for ruptured wide-necked aneurysms.
• Data collected included demographics, aneurysm characteristics, procedural complications, and clinical outcomes (modified Rankin Scale) at 30 days and 1 year.

Main Results:

• Technical success with complete angiographic cure was achieved in 93% of cases.
• Intraprocedural stent thrombosis occurred in two patients but resolved without neurological deficit.
• One patient died due to rebleeding; other deaths were unrelated to the procedure. High rates of antiplatelet therapy adherence were maintained.

Conclusions:

• Stent-assisted coiling is a safe and effective treatment for ruptured wide-necked intracranial aneurysms in the acute SAH setting.
• The procedure can be performed with acceptable risks, even in patients requiring ongoing antiplatelet therapy.