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Comparative Analysis of Long-Term Effect of Stent-Assisted Coiling in Unruptured Sidewall-Type and Terminal-Type

Shinichiro Teramoto1, Hidenori Oishi2, Hajime Arai2

  • 1Department of Neurosurgery, Koshigaya Municipal Hospital, Koshigaya City, Saitama, Japan.

World Neurosurgery
|March 12, 2019
PubMed

Insights

Stent-assisted coiling effectively treats sidewall and terminal aneurysms long-term. While it allows better coil packing for sidewall aneurysms, careful consideration is needed for terminal types.

Area of Science:

  • Neurosurgery
  • Interventional Radiology
  • Vascular Medicine

Background:

  • Stent-assisted coiling is an established method for inducing progressive aneurysm occlusion and preventing recurrence.
  • Understanding long-term outcomes based on aneurysm type (sidewall vs. terminal) and hemodynamic characteristics is crucial.

Purpose of the Study:

  • To comparatively analyze the long-term effects of stent-assisted coiling on sidewall-type and terminal-type aneurysms.
  • To investigate the correlation between initial occlusion status and 2-year follow-up outcomes for both aneurysm types.

Main Methods:

  • Retrospective analysis of 120 unruptured aneurysms in 116 patients undergoing stent-assisted coiling with 2-year follow-up.
  • Assessment of stent systems, baseline characteristics, and postcoiling occlusion status (complete occlusion, neck remnants, body filling).

Main Results:

  • Sidewall aneurysms were larger in dome size and parent vessel diameter compared to terminal aneurysms.
  • Initial occlusion status significantly correlated with 2-year outcomes for both sidewall and terminal aneurysms.
  • Sidewall aneurysms with immediate complete occlusion showed sustained non-remnant and non-filling at 2 years.

Conclusions:

  • Stent-assisted coiling facilitates higher coil packing in sidewall aneurysms.
  • Careful consideration of indications is advised for terminal-type aneurysms due to potential differences in long-term behavior.
Abstract

Keywords:
Sidewall-type aneurysmStent-assisted coilingTerminal-type aneurysmUnruptured intracranial aneurysm

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