Low profile visualized intraluminal support stent-assisted Hydrocoil embolization for acutely ruptured wide-necked intracranial aneurysms: A propensity score-matched cohort study

Clin Neurol Neurosurg. 2022 Jul:218:107302. doi: 10.1016/j.clineuro.2022.107302. Epub 2022 May 21.

Abstract

Purpose: To compare the safety and efficacy of low profile visualized intraluminal support (LVIS) stent-assisted hydrogel coil embolization and LVIS stent-assisted bare platinum coil embolization for acutely ruptured wide-necked intracranial.

Methods: 89 patients who underwent LVIS stent-assisted hydrogel coil embolization (hydrogel coil group) and 145 patients who underwent LVIS stent-assisted bare platinum coil embolization (platinum coil group) were retrospectively reviewed after 1:2 propensity score matching (PSM). Procedure-related complications, clinical and angiographic follow-up outcomes were compared between the two groups.

Results: All baseline characteristics were equivalent between hydrogel coil group and platinum coil group after PSM. There were no statistical differences in immediate postoperative embolization results, clinical and angiographic follow-up outcomes between the two groups (P = 0.514, P = 0.323 and P = 0.949, respectively). Intraprocedural aneurysm rupture, intraprocedural thrombosis and postprocedural thrombosis occurred in 2 patients (2.2%, 2/89), 1 patient (1.1%, 1/89) and 1 patient (1.1%, 1/89) of the hydrogel coil group compared with 1 patient (0.7%, 1/145), 1 patient (0.7%, 1/145) and 2 patients (1.4%, 2/145) of the platinum coil group, respectively (P = 0.559, P = 1.000 and P = 1.000). Nevertheless, the rate of postprocedural aneurysm early rebleeding in the hydrogel coil group was significantly lower than that in the platinum coil group (0.0% vs 4.8%, P = 0.046).

Conclusion: LVIS stent-assisted hydrogel coil embolization may reduce the risk of aneurysm early rebleeding compared with LVIS stent-assisted bare platinum coil embolization for the treatment of acutely ruptured wide-necked intracranial aneurysms, which implies that hydrogel coil may improve the safety of stent placement for ruptured intracranial aneurysms.

Keywords: Coil; Complication; Hydro; Intracranial aneurysm; Propensity score; Stent.

MeSH terms

  • Aneurysm, Ruptured* / surgery
  • Aneurysm, Ruptured* / therapy
  • Cerebral Angiography / methods
  • Cohort Studies
  • Embolization, Therapeutic* / adverse effects
  • Embolization, Therapeutic* / methods
  • Endovascular Procedures* / methods
  • Humans
  • Hydrogels
  • Intracranial Aneurysm* / surgery
  • Intracranial Aneurysm* / therapy
  • Platinum
  • Propensity Score
  • Retrospective Studies
  • Stents
  • Treatment Outcome

Substances

  • Hydrogels
  • Platinum