Universität zu Köln

Goertz, Lukas, Liebig, Thomas, Pennig, Lenhard, Timmer, Marco, Styczen, Hanna, Grunz, Jan-Peter, Lichtenstein, Thorsten, Schlamann, Marc and Kabbasch, Christoph (2021). Propensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms. Sci Rep, 11 (1). BERLIN: NATURE PORTFOLIO. ISSN 2045-2322

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Abstract

Stent-assisted coiling (SAC) for ruptured intracranial aneurysms (RIAs) remains controversial due to an inherent risk of potential thromboembolic and hemorrhagic complications. We compared SAC and coiling alone for the management of RIAs using propensity score-adjustment. Sixty-four patients treated by SAC and 220 by stand-alone coiling were retrospectively reviewed and compared using inverse probability of treatment weighting (IPTW) with propensity scores. Functional outcome, procedure-related and overall complications and angiographic results were analyzed. Aneurysms treated by SAC had a larger diameter, a wider neck and were more frequently located at the posterior circulation. SAC had a higher risk for thromboembolic complications (17.2% vs. 7.7%, p = 0.025), however, this difference did not persist in the IPTW analysis (OR 1.2, 95% CI 0.7-2.3, adjusted p = 0.458). In the adjusted analysis, rates of procedural cerebral infarction (p = 0.188), ventriculostomy-related hemorrhage (p = 0.584), in-hospital mortality (p = 0.786) and 6-month favorable functional outcome (p = 0.471) were not significantly different between the two groups. SAC yielded a higher complete occlusion (80.0% vs. 67.2%, OR 3.2, 95% CI 1.9-5.4, p < 0.001) and a lower recanalization rate (17.5% vs. 26.1%, OR 0.3, 95% CI 0.2-0.6, p < 0.001) than stand-alone coiling at 6-month follow-up. In conclusion, SAC of large and wide-necked RIAs provided higher aneurysm occlusion and similar clinical outcome, when compared to stand-alone coiling.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Pennig, Lenhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmer, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Styczen, Hanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Grunz, Jan-Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Lichtenstein, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlamann, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-584737
DOI:	10.1038/s41598-021-01156-y
Journal or Publication Title:	Sci Rep
Volume:	11
Number:	1
Date:	2021
Publisher:	NATURE PORTFOLIO
Place of Publication:	BERLIN
ISSN:	2045-2322
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DUAL ANTIPLATELET THERAPY; ENDOVASCULAR TREATMENT; CEREBRAL ANEURYSMS; COMPLICATIONS; EMBOLIZATION; FEASIBILITY; PLACEMENT; EFFICACY; SAFETY; RISK Multiple languages Multidisciplinary Sciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58473