Is packing density important in stent-assisted coiling?

Neurosurgery
Nohra ChalouhiPascal Jabbour

Abstract

Recent reports have shown that stent-assisted coiling (SAC) is associated with lower aneurysm recanalization rates compared with conventional coiling, raising questions about the necessity of achieving high packing density (PD) in stented aneurysms. To assess the impact of PD on follow-up obliteration rates of stented aneurysms and attempt to determine the optimal range of PD in SAC. This is a retrospective analysis of a single, large, cerebrovascular referral center's experience over a 5-year period in SAC with the use of Neuroform and Enterprise stents. The rate of complete obliteration on follow-up angiograms was compared for 3 different PD groups: high PD (>22%), moderate PD (12-22%), and low PD (<12%). There were 292 stent-coiled aneurysms (36 ruptured, 256 unruptured) with available angiographic follow-up. Mean PD was 15.2%, and complete obliteration rate was 79.5% at latest follow-up. The rates of complete obliteration were significantly higher in the moderate (86.4%; OR = 2.58; P = .006) and high PD groups (85.3%; OR = 2.35; P = .037) compared with the low PD group (71.1%). However, no statistically significant difference was found between the moderate and high PD groups (OR = 0.91; P = .84). In multivariate analysis, P...Continue Reading

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Citations

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