Influences of stents on the outcome of coil embolized intracranial aneurysms: Comparison between a stent-remodeled and non-remodeled treatment

Purpose: The influences of a stent on the outcome of embolized aneurysms are not well known. The purpose of this study is to assess and compare the angiographic follow-up (FU) results of stent-remodeled (StR) and non-remodeled (nonR) coil embolization of intracranial aneurysms. Methods: Thirty-seven StR patients with FU digital subtraction angiography (DSA) were matched with 37 nonR patients according to presentation (ruptured or unruptured), location of the aneurysm (sidewall or bifurcation), initial sac occlusion (complete/near complete or incomplete/failure), and the sac size (largest diameter/less than 2 mm difference). The baseline clinical and aneurysm characteristics, initial/FU treatment success rates, and FU DSA findings between the StR and nonR groups with regard to the morphologic features (size and location) of the aneurysms were assessed and compared. Results: The StR group showed more frequent progressive thrombosis compared to the nonR group (56.8 vs. 27.0%; p<0.05). These differences were more prominent for small aneurysms (70 vs. 25%; p<0.05). Small aneurysms showed a lower rate of FU recanalization in the StR group compared to the nonR group (0 vs. 25%; p<0.05). Sidewall aneurysms also showed a higher rate of progressive thrombosis in the StR group (61.1 vs. 27.8%; p<0.05). Conclusions: Coil embolization is an effective treatment method for intracranial aneurysms, however, changes on follow-up may affect the long-term outcome. Stent remodeling may aid in preserving and enhancing the treatment durability especially in small aneurysms.