Purpose

Low-profile intracranial stents are characterized by a miniaturized design that enables deployment via a 0.0165″ or 0.017″ internal diameter microcatheter, which is typically intended for coil delivery. This study analyzed the incidence, clinical relevance and risk factors of thromboembolic events (TEE) occurring during low-profile stent-assisted coiling of intracranial aneurysms.

Methods

This was a retrospective, multicenter analysis of consecutive patients who underwent stent-assisted aneurysm coiling (SAC) with the laser-cut Acandis Acclino and Neuroform Atlas stents. The study evaluated the incidence of symptomatic and asymptomatic TEEs and the impact on functional outcome. Risk factors for TEEs were determined by univariate and bivariate logistic regression analyses.

Results

Among 131 procedures (mean patient age 56.5 ± 12.8 years, mean aneurysm size: 6.7 ± 3.9 mm) TEEs occurred in 14 cases (10.7%) of which 2 patients (1.5%) developed ischemic stroke, while the remaining TEEs remained asymptomatic. Multivariate analysis revealed Y‑stenting as potential risk factor for TEEs (odds ratio: 3.9, 95% confidence interval: 1.0–16.5; p = 0.08).

Conclusion

The use of SAC with low-profile intracranial stents is associated with a favorable safety profile; however, Y‑stenting may carry an increased risk of TEEs, which needs to be considered during treatment planning.

中文翻译：

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用于颅内动脉瘤血管内治疗的薄型激光切割支架

目的

薄型颅内支架的特点是采用小型化设计，可通过 0.0165" 或 0.017" 内径微导管进行部署，通常用于线圈输送。本研究分析了颅内动脉瘤支架辅助栓塞术期间血栓栓塞事件 (TEE) 的发生率、临床相关性和危险因素。

方法

这是对使用激光切割 Acandis Acclino 和 Neuroform Atlas 支架进行支架辅助动脉瘤栓塞 (SAC) 的连续患者的回顾性多中心分析。该研究评估了有症状和无症状 TEE 的发生率以及对功能结果的影响。TEE 的危险因素通过单变量和双变量逻辑回归分析确定。

结果

在 131 次手术（平均患者年龄 56.5 ± 12.8 岁，平均动脉瘤大小：6.7 ± 3.9 毫米）中，14 例（10.7%）发生 TEE，其中 2 例（1.5%）发生缺血性卒中，其余 TEE 保持无症状。多变量分析显示 Y 型支架是 TEE 的潜在风险因素（优势比：3.9，95% 置信区间：1.0-16.5；p  = 0.08）。

结论

将 SAC 与小尺寸颅内支架一起使用具有良好的安全性；然而，Y 型支架可能会增加 TEE 的风险，这需要在治疗计划中加以考虑。