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Densidad Óptima de Empaquetamiento de Bobinas para la Obliteración Completa Aneurismal en la Derivación de Flujo: Un

Ryosuke Maeoka^1,2, Hiroyuki Ohnishi², Shohei Yokoyama¹

¹Department of Neurosurgery Nara Medical University Nara Japan.

Stroke (Hoboken, N.J.)

|January 23, 2026

Resumen

La densidad de empaquetamiento óptima (PD) para stent derivador de flujo (FDS) con embolización con bobina (CE) en aneurismas grandes puede ser del 8,9 %. Alcanzar esta PD puede lograr la obliteración completa, lo que podría reducir los procedimientos de CE innecesarios.

Área de la Ciencia:

Neurocirugía
Radiología Intervencionista
Neurología Vascular

Sus antecedentes:

El despliegue del stent derivador de flujo (FDS) combinado con la embolización con bobina (CE) es eficaz para el tratamiento de aneurismas cerebrales.
La densidad de empaquetamiento óptima (PD) para FDS y CE en aneurismas grandes o gigantes sigue sin definirse.
Este estudio investiga la PD ideal para maximizar la eficacia del tratamiento.

Objetivo del estudio:

Determinar la densidad de empaquetamiento óptima (PD) para el despliegue del stent derivador de flujo (FDS) con embolización con bobina (CE).
Evaluar la asociación entre la PD y la obliteración completa (CO) en aneurismas intracraneales grandes o gigantes.

Principales métodos:

Estudio multicéntrico retrospectivo de 97 pacientes con aneurismas no rotos grandes/gigantes tratados con FDS solo o FDS + CE.
PD de bobina calculada como relación de embolización de volumen; obliteración completa definida por la escala de calificación O'Kelly-Marotta D a los 6 meses.
Análisis de las asociaciones entre PD y CO utilizando modelos univariable y multivariable.

Principales resultados:

Una relación de embolización de volumen (PD) de ≥ 8,9 % se asoció significativamente con la obliteración completa (CO).
Una PD más alta mostró una fuerte correlación con la CO tanto en análisis univariable (OR 14,3) como multivariable (OR 10,5).
Mientras que el grupo FDS + CE mostró tasas de CO más altas (82,3 % frente al 50,0 %), el hallazgo clave fue el umbral de PD.

Conclusiones:

Una densidad de empaquetamiento del 8,9 % de la relación de embolización de volumen puede ser suficiente para lograr la obliteración completa en aneurismas intracraneales grandes o gigantes tratados con FDS + CE.
La embolización con bobina adicional más allá de este umbral puede no ser necesaria, lo que podría optimizar el procedimiento.
Este hallazgo podría guiar la toma de decisiones clínicas para optimizar las estrategias de tratamiento de FDS y CE.

Palabras clave:

embolización con bobina stent derivador de flujo aneurismas grandes o gigantes densidad de empaquetamiento ratio de embolización de volumen

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