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Safety and efficacy of stent-assisted coiling ruptured intracranial aneurysms: A single-center experience

Deng-Xiang Zhang1, Chao-Bao Luo2,3, Chien-Hui Lee1

  • 1Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.

Tzu Chi Medical Journal
|May 5, 2025
PubMed

Insights

Stent-assisted coiling (SAC) is a safe and effective treatment for ruptured intracranial aneurysms, showing no increased risk of rebleeding despite dual antiplatelet therapy. Outcomes were favorable, with low recurrence rates.

Area of Science:

  • Neurosurgery
  • Endovascular Therapy
  • Cerebrovascular Disease

Background:

  • Endovascular coiling is a minimally invasive treatment for intracranial aneurysms.
  • Stent-assisted coiling (SAC) requires dual antiplatelet treatment for ruptured intracranial aneurysms.
  • Managing ruptured aneurysms with SAC necessitates careful consideration of antiplatelet therapy risks.

Purpose of the Study:

  • To evaluate the safety and efficacy of stent-assisted coiling (SAC) for acutely ruptured intracranial aneurysms.
  • To assess procedure-related complications, rebleeding, and recurrence rates after SAC.
  • To determine clinical outcomes in patients treated with SAC for ruptured aneurysms.

Main Methods:

  • Retrospective collection of data from patients undergoing SAC for ruptured intracranial aneurysms over 2 years.
  • Analysis of procedure-related complications, aneurysm rebleeding and recurrence rates.
  • Evaluation of clinical outcomes using Glasgow Outcome Score and modified Rankin Scale (mRS).

Main Results:

  • No periprocedural hemorrhagic complications or rebleeding before discharge in 17 patients.
  • Two patients experienced acute brain infarction due to symptomatic vasospasm.
  • Posterior circulation involvement and Hunt and Hess grade ≥3 were associated with poorer functional outcomes (mRS).

Conclusions:

  • Stent-assisted coiling (SAC) is technically feasible and safe for ruptured intracranial aneurysms.
  • SAC does not increase the risk of postoperative aneurysm rebleeding despite dual antiplatelet therapy.
  • SAC demonstrates low rates of aneurysm regrowth and coil compaction, supporting its use as an effective treatment option.
Abstract

Keywords:
Endovascular coilingRuptured intracranial aneurysmStent-assisted coilingTransarterial embolization

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