Journal article
The safety and efficacy of stent-assisted coiling for acutely ruptured cerebral aneurysms: a multicenter prospective registry study (SAVE)
International journal of surgery (London, England), Vol.111(6), pp.3876-3885
06/2025
DOI: 10.1097/JS9.0000000000002357
PMCID: PMC12165586
PMID: 40146285
Abstract
Stent-assisted coiling (SAC) is a reasonable treatment for ruptured cerebral aneurysms that are not amenable to primary coiling. However, the safety and efficacy of SAC for acutely ruptured cerebral aneurysms need to be further determined.
To evaluate the safety and efficacy of SAC for acutely ruptured cerebral aneurysms.
This was a prospective, multicenter study of consecutive patients with acutely ruptured cerebral aneurysms treated with SAC within 72 hours after presentation. The primary outcome was treatment-related thromboembolic complications within 30 days of treatment; the secondary outcomes were hemorrhagic complications and aneurysm recurrence. A favorable clinical outcome was defined as a modified Rankin scale (mRS) of 0 to 2 at 6 months after treatment.
Of the 315 patients, 278 patients with 278 acutely ruptured aneurysms were included in the study. Treatment-related thromboembolic complications occurred in 32 patients (11.5%), including nine (3.2%) patients with intraoperative thrombosis and 23 (8.3%) patients with postoperative ischemia. Hemorrhagic complications occurred in 13 (4.7%) patients, including one (0.4%) patient with intraoperative hemorrhage and 12 (4.3%) patients with postoperative hemorrhage. Aneurysm rebleeding occurred in two (0.7%) patients. A total of 251 (251/275, 91.3%) patients had favorable clinical outcomes at the 6-month follow-up. The rate of aneurysm recurrence was 7.2%. Patients with a worse WFNS grade tended to have thromboembolic complications (21.2% vs. 10.2%, P = 0.079) and hemorrhagic complications (12.1% vs. 3.7%, P = 0.054). Treatment-related thromboembolic complications and hemorrhagic complications were independent predictors of unfavorable clinical outcomes.
Most patients had favorable clinical outcomes, with a low risk of intraoperative complications, aneurysm rebleeding, and a high rate of aneurysm occlusion. SAC for acutely ruptured aneurysms is a safe and effective procedure, especially in patients with good clinical conditions before treatment.
Details
- Title: Subtitle
- The safety and efficacy of stent-assisted coiling for acutely ruptured cerebral aneurysms: a multicenter prospective registry study (SAVE)
- Creators
- Gaozhi Li - Renji HospitalShenghao Ding - Renji HospitalJiale Wang - Wenzhou Medical UniversityKuang Zheng - First Affiliated Hospital of Wenzhou Medical UniversityWenshuai Li - Heze Municipal HospitalGuohua Mao - Second Affiliated Hospital of Nanchang UniversityXiaobo Liu - Zhejiang UniversityZheming Zhang - Dalian University of TechnologyDianshi Jin - Dalian Municipal Central HospitalLang Liu - Renji HospitalQinhua Guo - Shanghai Jiao Tong UniversityQingyuan Liu - Capital Medical UniversityXiaohua Zhang - Renji HospitalEdgar Samaniego - University of IowaRose Du - Brigham and Women's HospitalYaohua Pan - Renji HospitalJieqing Wan - Renji HospitalBing Zhao - Renji Hospital
- Resource Type
- Journal article
- Publication Details
- International journal of surgery (London, England), Vol.111(6), pp.3876-3885
- DOI
- 10.1097/JS9.0000000000002357
- PMID
- 40146285
- PMCID
- PMC12165586
- NLM abbreviation
- Int J Surg
- ISSN
- 1743-9159
- eISSN
- 1743-9159
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Grant note
- Noncommunicable Chronic Diseases-National Science and Technology Major Project: 2023ZD0505100/101 National Facility for Translational MedicineNational Facility for Translational Medicine (Shanghai): TMSK-2021-147 Shanghai Science and Technology Project: 21Y11906200 Renji Hospital research project: RJPY-DZX-001
The work was supported by Noncommunicable Chronic Diseases-National Science and Technology Major Project (2023ZD0505100/101), the National Facility for Translational Medicine (Shanghai TMSK-2021-147), the Shanghai Science and Technology Project (21Y11906200), and the Renji Hospital research project (RJPY-DZX-001). The study sponsors were not involved in the collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.
- Language
- English
- Electronic publication date
- 03/28/2025
- Date published
- 06/2025
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984802502102771
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