Stent-assisted coiling versus coiling alone of ruptured anterior communicating artery aneurysms: A single-center experience

• Stent-assited coiling associated with a high risk of intraprocedural complications.
• Stent-assited coiling associated with a lower rate of immediate occlusion rate.
• Postprocedural complications and clincial outcomes did not differ between groups.
• Long-term angiographic results and clinical outcomes require further study.

ObjectiveEndovascular coiling of anterior communicating artery (ACoA) aneurysms has evolved; however, stent-assisted coiling of ruptured aneurysms remains controversial. We aimed to compare periprocedural complications, angiographic and clinical outcomes after stent-assisted coiling with coiling alone of ruptured ACoA aneurysms.MethodsWe performed a retrospective review of consecutive 222 patients with ruptured ACoA aneurysms treated with endovascular coiling within 7 days after ictus. Patients were grouped into stent-assisted coiling and coiling alone groups. Baseline characteristics, periprocedural complications, clinical outcomes, and angiographic results were compared between the two groups.Results63 (28.4%) patients underwent stent-assisted coiling and 159 (71.6%) underwent coiling alone. There were no statistically significant differences in age, sex, clinical grading and Fisher grade. Larger aneurysms (P = 0.002) and wider-neck aneurysms (P < 0.001) were more often treated with stent-assisted coiling within 72 h (P = 0.025). Intraprocedural aneurysm rupture occurred in 6 (9.5%) patients treated with stent-assisted coiling compared with in 5 (3.1%) treated with coiling alone (P < 0.048). Thrombus formation occurred in 10 (15.9%) patients after stent-assisted coiling compared with 6 (3.8%) after coiling alone (P = 0.002). Stent-assisted coiling achieved a lower rate of immediate occlusion than coiling alone (P = 0.045). Postoperative complications, clinical outcomes, and follow-up aneurysm occlusion did not significantly differ.ConclusionsStent-assisted coiling of ruptured ACoA aneurysms was associated with a higher rate of intraprocedural complications and associated with a lower immediate occlusion rate. However, Postoperative complications and clinical outcomes did not differ. Long-term angiographic results require further study.