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Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms.

Publication ,  Journal Article
Chalouhi, N; Tjoumakaris, S; Starke, RM; Gonzalez, LF; Randazzo, C; Hasan, D; McMahon, JF; Singhal, S; Moukarzel, LA; Dumont, AS; Jabbour, P ...
Published in: Stroke
August 2013

BACKGROUND AND PURPOSE: Flow diversion has emerged as an important tool for the management of intracranial aneurysms. The purpose of this study was to compare flow diversion and traditional embolization strategies in terms of safety, efficacy, and clinical outcomes in patients with unruptured, large saccular aneurysms (≥10 mm). METHODS: Forty patients treated with the Pipeline Embolization Device (PED) were matched in a 1:3 fashion with 120 patients treated with coiling based on patient age and aneurysm size. Fusiform and anterior communicating artery aneurysms were eliminated from the analysis. Procedural complications, angiographic results, and clinical outcomes were analyzed and compared. RESULTS: There were no differences between the 2 groups in terms of patient age, sex, aneurysm size, and aneurysm location. The rate of procedure-related complications did not differ between the PED (7.5%) and the coil group (7.5%; P=1). At the latest follow-up, a significantly higher proportion of aneurysms treated with PED (86%) achieved complete obliteration compared with coiled aneurysms (41%; P<0.001). In multivariable analysis, coiling was an independent predictor of nonocclusion. Retreatment was necessary in fewer patients in the PED group (2.8%) than the coil group (37%; P<0.001). A similar proportion of patients attained a favorable outcome (modified Rankin Scale, 0-2) in the PED group (92%) and in the coil group (94%; P=0.8). CONCLUSIONS: The PED provides higher aneurysm occlusion rates than coiling, with no additional morbidity and similar clinical outcomes. These findings suggest that the PED might be a preferred treatment option for large unruptured saccular aneurysms.

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Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

August 2013

Volume

44

Issue

8

Start / End Page

2150 / 2154

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Regional Blood Flow
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Magnetic Resonance Angiography
  • Intracranial Aneurysm
  • Humans
  • Hemostatic Techniques
 

Citation

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Chicago
ICMJE
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Chalouhi, N., Tjoumakaris, S., Starke, R. M., Gonzalez, L. F., Randazzo, C., Hasan, D., … Jabbour, P. (2013). Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms. Stroke, 44(8), 2150–2154. https://doi.org/10.1161/STROKEAHA.113.001785
Chalouhi, Nohra, Stavropoula Tjoumakaris, Robert M. Starke, L Fernando Gonzalez, Ciro Randazzo, David Hasan, Jeffrey F. McMahon, et al. “Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms.Stroke 44, no. 8 (August 2013): 2150–54. https://doi.org/10.1161/STROKEAHA.113.001785.
Chalouhi N, Tjoumakaris S, Starke RM, Gonzalez LF, Randazzo C, Hasan D, et al. Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms. Stroke. 2013 Aug;44(8):2150–4.
Chalouhi, Nohra, et al. “Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms.Stroke, vol. 44, no. 8, Aug. 2013, pp. 2150–54. Pubmed, doi:10.1161/STROKEAHA.113.001785.
Chalouhi N, Tjoumakaris S, Starke RM, Gonzalez LF, Randazzo C, Hasan D, McMahon JF, Singhal S, Moukarzel LA, Dumont AS, Rosenwasser R, Jabbour P. Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms. Stroke. 2013 Aug;44(8):2150–2154.

Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

August 2013

Volume

44

Issue

8

Start / End Page

2150 / 2154

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Regional Blood Flow
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Magnetic Resonance Angiography
  • Intracranial Aneurysm
  • Humans
  • Hemostatic Techniques