A Comprehensive Analysis of Stent during Stent Assisted Coil Embolization for Cerebral Aneurysms: A 17-Year Institutional Study

Abstract

Aim: To compare the outcomes and complications of stent-assisted coil (SAC) embolization for the treatment of cerebral aneurysms according to stent type.

Material and methods: Since January 2006, a total of 1293 patients have been added to our institutional aneurysm database. We excluded cases with subarachnoid hemorrhage, those not classified as Raymond Roy Class 1, and those in which flow diverters were used. Cases involving the use of overlapping stents, Y-stenting, or multiple stents were also excluded. We recorded demographic information, aneurysm characteristics, and procedural details for all patients. Patients who did not undergo diffusionweighted magnetic resonance imaging (MRI) within 1 day postoperatively or follow-up angiography within 6 months postoperatively were excluded.

Results: In total, 188 patients were included in the analysis (129 females; mean age, 58 years) who were treated for aneurysms of different sizes. Regrowth occurred in 21 patients, with the rate varying according to the stent type. In particular, the lower profile stent group had a lower regrowth rate compared to the nitinol laser stent group. The rate of postoperative infarction on diffusionweighted MRI within 1 day postoperatively varied among stent types.

Conclusion: None of the stent types demonstrated clear superiority for SAC embolization, indicating that stent selection should be based on surgeon preference. Despite the low regrowth rate, careful stent selection is essential, particularly for patients at high risk of ischemic stroke or regrowth. These findings provide valuable insights for optimizing the treatment of cerebral aneurysms using SAC embolization.