The authors¹ report retrospectively on a series of patients with aneurysmal subarachnoid hemorrhage who underwent primary coiling (207 patients) compared to a group of patients who underwent stent-assisted coiling with the Low-profile Visualized Intraluminal Support (LVIS) stent (207 patients). They concluded that long-term aneurysm occlusion and recurrence rates were better in the LVIS group. The study shows a trend toward an increase in hemorrhagic complication rates, specifically for aneurysm reruptures, though not statistically significant. This is interesting given the fact that the objective of stent-assisted coiling (SAC) is greater coil packing of the aneurysm to prevent rerupture. It is unclear why this is, as this is not reported as intraoperative rupture or procedural complications, and the long-term occlusion rate is better. Perhaps the need for an anticoagulation and antiplatelet regimen is a contributing factor. While many reviews, including this one, have shown that SAC can be performed safely in patients with subarachnoid hemorrhage (SAH), we still strive for an endovascular solution for wide-necked aneurysms that does not require antiplatelet agents.

中文翻译：

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评论：比较低矮的可视化腔内支架支架辅助线圈和仅用于急性破裂的颅内动脉瘤的线圈：基于倾向评分匹配的队列研究的安全性和有效性。

作者¹回顾性报道了一系列经历了原发性盘绕的动脉瘤性蛛网膜下腔出血的患者（207例），与一组采用低轮廓可视化腔内支架（LVIS）支架进行了支架辅助卷绕的患者（207例）进行了比较。他们得出结论，LVIS组的长期动脉瘤闭塞和复发率更高。该研究显示出血并发症发生率呈上升趋势，特别是对于动脉瘤破裂，尽管无统计学意义。考虑到以下事实，这很有趣，即支架辅助卷绕（SAC）的目的是增大动脉瘤的线圈堆积以防止破裂。目前尚不清楚为什么会这样，因为没有报道为术中破裂或手术并发症，而且长期闭塞率较好。可能需要抗凝和抗血小板治疗是一个促成因素。尽管包括该评论在内的许多评论都表明，蛛网膜下腔出血（SAH）患者可以安全地进行SAC，但我们仍在努力寻找不需要抗血小板药物的宽颈动脉瘤血管内解决方案。