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Research ArticleNeurointervention

Safety and Efficacy of Stent-Assisted Coiling of Unruptured Intracranial Aneurysms Using Low-Profile Stents in Small Parent Arteries

J. Kim, H.J. Han, W. Lee, S.K. Park, J. Chung, Y.B. Kim and K.Y. Park
American Journal of Neuroradiology September 2021, 42 (9) 1621-1626; DOI: https://doi.org/10.3174/ajnr.A7196
J. Kim
aFrom the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.)
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  • ORCID record for J. Kim
H.J. Han
aFrom the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.)
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  • ORCID record for H.J. Han
W. Lee
bSeverance Stroke Center, and Department of Neurosurgery (W.L., S.K.P.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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S.K. Park
bSeverance Stroke Center, and Department of Neurosurgery (W.L., S.K.P.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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J. Chung
aFrom the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.)
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Y.B. Kim
aFrom the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.)
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K.Y. Park
aFrom the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.)
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    FIGURE.

    Inclusion and exclusion flow diagram.

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    Table 1:

    Details of endovascular procedures

    VariablesValues
    Platelet function test
     PRU (SD)187.7 (67.1)
     Clopidogrel hyporesponder (No.) (%)23 (34.8)a
    Stent type (No.) (%)
     LVIS Jr22 (33.3)
     Neuroform Atlas44 (66.7)
    No. of stents (No.) (%)
     159 (89.4)
     27 (10.6)b
    • ↵a Modified with cilostazol (100 mg twice daily).

    • ↵b Including 6 Y-stent placements.

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    Table 2:

    Procedure-related complications and 90-day clinical outcomes

    Clinical OutcomesValues
    Procedure-related complications (No.) (%)10 (15.2)
     Thromboembolism8 (12.1)a
     Hemorrhage2 (3.0)
    Unfavorable outcome (mRS ≥3) (No.) (%)3 (4.5)
    Procedure-related mortality (No.) (%)0
    • ↵a Including 7 asymptomatic cases.

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    Table 3:

    Radiologic outcomes

    Aneurysm Occlusion ClassificationValues
    Immediate postprocedural (No.) (%)
     RR I38 (57.6)
     RR II13 (19.7)
     RR III15 (22.7)
    Follow-up occlusion (median, 12.1 mo) (No.) (%)
     RR I51 (87.9)
     RR II4 (6.9)
     RR III3 (5.2)
    Recurrence (No.) (%)2 (3.4%)a
    In-stent stenosis (No.) (%)0 (0%)
    • ↵a Neither of these patients required retreatment.

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    Table 4:

    Multivariate analysis of risk factors for procedure-related complications

    VariablesOdds Ratio95% Wald CIP Value
    Age1.080.99–1.19.086
    Female sex5.380.61–47.72.131
    Current smoking7.101.35–37.50.021a
    Diabetes mellitus3.250.15–72.60.457
    Cardiovascular disease2.240.15–33.63.560
    Parent artery diameter18.400.126–2694.60.252
    RR I2.300.23–22.94.478
    • ↵a Statistically significant.

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American Journal of Neuroradiology: 42 (9)
American Journal of Neuroradiology
Vol. 42, Issue 9
1 Sep 2021
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Cite this article
J. Kim, H.J. Han, W. Lee, S.K. Park, J. Chung, Y.B. Kim, K.Y. Park
Safety and Efficacy of Stent-Assisted Coiling of Unruptured Intracranial Aneurysms Using Low-Profile Stents in Small Parent Arteries
American Journal of Neuroradiology Sep 2021, 42 (9) 1621-1626; DOI: 10.3174/ajnr.A7196

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Safety and Efficacy of Stent-Assisted Coiling of Unruptured Intracranial Aneurysms Using Low-Profile Stents in Small Parent Arteries
J. Kim, H.J. Han, W. Lee, S.K. Park, J. Chung, Y.B. Kim, K.Y. Park
American Journal of Neuroradiology Sep 2021, 42 (9) 1621-1626; DOI: 10.3174/ajnr.A7196
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