Propensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms

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 patient...

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Autores principales:	Lukas Goertz, Thomas Liebig, Lenhard Pennig, Marco Timmer, Hanna Styczen, Jan-Peter Grunz, Thorsten Lichtenstein, Marc Schlamann, Christoph Kabbasch
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1963ac6b5e9849fea7685f9dae296a68
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spelling	oai:doaj.org-article:1963ac6b5e9849fea7685f9dae296a682021-11-08T10:51:53ZPropensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms10.1038/s41598-021-01156-y2045-2322https://doaj.org/article/1963ac6b5e9849fea7685f9dae296a682021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01156-yhttps://doaj.org/toc/2045-2322Abstract 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.Lukas GoertzThomas LiebigLenhard PennigMarco TimmerHanna StyczenJan-Peter GrunzThorsten LichtensteinMarc SchlamannChristoph KabbaschNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lukas Goertz Thomas Liebig Lenhard Pennig Marco Timmer Hanna Styczen Jan-Peter Grunz Thorsten Lichtenstein Marc Schlamann Christoph Kabbasch Propensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms
description	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.
format	article
author	Lukas Goertz Thomas Liebig Lenhard Pennig Marco Timmer Hanna Styczen Jan-Peter Grunz Thorsten Lichtenstein Marc Schlamann Christoph Kabbasch
author_facet	Lukas Goertz Thomas Liebig Lenhard Pennig Marco Timmer Hanna Styczen Jan-Peter Grunz Thorsten Lichtenstein Marc Schlamann Christoph Kabbasch
author_sort	Lukas Goertz
title	Propensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms
title_short	Propensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms
title_full	Propensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms
title_fullStr	Propensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms
title_full_unstemmed	Propensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms
title_sort	propensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1963ac6b5e9849fea7685f9dae296a68
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Propensity score-adjusted analysis on stent-assisted coiling versus coiling alone for ruptured intracranial aneurysms

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