The authors compared the contemporary perioperative procedure-related complications between coiling with
stent placement and coiling without
stent placement for acutely
ruptured aneurysms treated in a single center after improvement of interventional skills and strategy.
METHODS: In an institutional review board-approved protocol, 133 patients who underwent coiling with
stent placement and 289 patients who underwent coiling without
stent placement from January 2012 to December 2014 were consecutively reviewed retrospectively. Baseline characteristics, procedure-related complications and mortality rate, angiographic follow-up results, and clinical outcomes were compared between the two groups. Univariate analysis and logistic regression analysis were performed to determine the association of procedure-related complications of coiling with
stent placement with potential risk factors.
RESULTS: The coiling/
stent group and coiling/no-
stent group were statistically comparable with respect to all baseline characteristics except for
aneurysm location (p < 0.001) and parent artery configuration (p = 0.024). The immediate embolization results and clinical outcomes between the two groups showed no significant differences (p = 0.807 and p = 0.611, respectively). The angiographic follow-up results of the coiling in
stent group showed a significant higher occlusion rate and lower recurrence rate compared with the coiling/no-
stent group (82.5% vs 66.7%, 3.5% vs 14.5%, p = 0.007). Procedure-related intraoperative
rupture and
thrombosis, postoperative early rebleeding and
thrombosis, and external ventricular drainage-related hemorrhagic event occurred in 3.0% (4 of 133), 2.3% (3 of 133), 1.5% (2 of 133), 0.7% (1 of 133), and 0.8% (1 of 133) of the coiling/
stent group compared with 1.0% (3 of 289), 1.4% (4 of 289), 1.4% (4 of 289), and 0.7% (2 of 289) of the coiling/no-
stent group, respectively (p = 0.288, p = 0.810, p = 1.000, p = 0.315, and p = 1.000, respectively). One patient presented with coil protrusion in the group of coiling without
stent. The procedure-related mortality was 1.5% (2 of 133) in the coiling/
stent group and 0.7% in the coiling/no-
stent group (p = 0.796). Multivariable analysis showed no significant predictors for the total perioperative procedure-related complications, hemorrhagic complications, or ischemic complications.
CONCLUSIONS: The perioperative procedure-related complications and mortality rate did not differ significantly between the coiling/
stent group and the coiling/no-
stent group for patients with acutely
ruptured aneurysms. Considering the better angiographic follow-up results, coiling with
stent placement might be a feasible, safe, and promising option for treatment in the acute phase of selected wide-necked ruptured
intracranial aneurysms.