Journal article
Is Packing Density Important in Stent-Assisted Coiling?
Neurosurgery, Vol.71(2), pp.381-387
08/01/2012
DOI: 10.1227/NEU.0b013e31825c36dd
PMID: 22569059
Abstract
Abstract BACKGROUND: Recent reports have shown that stent-assisted coiling (SAC) is associated with lower aneurysm recanalization rates compared with conventional coiling, raising questions about the necessity of achieving high packing density (PD) in stented aneurysms. OBJECTIVE: To assess the impact of PD on follow-up obliteration rates of stented aneurysms and attempt to determine the optimal range of PD in SAC. METHODS: This is a retrospective analysis of a single, large, cerebrovascular referral center's experience over a 5-year period in SAC with the use of Neuroform and Enterprise stents. The rate of complete obliteration on follow-up angiograms was compared for 3 different PD groups: high PD (>22%), moderate PD (12–22%), and low PD (<12%). RESULTS: There were 292 stent-coiled aneurysms (36 ruptured, 256 unruptured) with available angiographic follow-up. Mean PD was 15.2%, and complete obliteration rate was 79.5% at latest follow-up. The rates of complete obliteration were significantly higher in the moderate (86.4%; OR = 2.58; P = .006) and high PD groups (85.3%; OR = 2.35; P = .037) compared with the low PD group (71.1%). However, no statistically significant difference was found between the moderate and high PD groups (OR = 0.91; P = .84). In multivariate analysis, PD was a significant predictor of complete obliteration (P = .007) along with smaller aneurysm volumes (P = .004). Ruptured (P = .002) and cavernous aneurysms (P < .001) had significantly lower obliteration rates. CONCLUSION: High obliteration rates at follow-up were observed despite modest packing of stented aneurysms. Although PD is a definite factor in SAC, moderate and high packing of stented aneurysms seems to provide equivalent angiographic obliteration rates at follow-up.
Details
- Title: Subtitle
- Is Packing Density Important in Stent-Assisted Coiling?
- Creators
- Nohra Chalouhi - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaAaron S Dumont - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaDavid Hasan - Department of Neurosurgery, University of Iowa, Iowa City, IowaStavropoula Tjoumakaris - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaL. Fernando Gonzalez - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaRobert M Starke - Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, VirginiaRichard Dalyai - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaSedeek El Moursi - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaRobert Rosenwasser - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PennsylvaniaPascal Jabbour - Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
- Resource Type
- Journal article
- Publication Details
- Neurosurgery, Vol.71(2), pp.381-387
- DOI
- 10.1227/NEU.0b013e31825c36dd
- PMID
- 22569059
- NLM abbreviation
- Neurosurgery
- ISSN
- 0148-396X
- eISSN
- 1524-4040
- Language
- English
- Date published
- 08/01/2012
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040382102771
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