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Stent-assisted coiling and balloon-assisted coiling in the management of intracranial aneurysms: A systematic review & meta-analysis

Published:March 25, 2016DOI:https://doi.org/10.1016/j.jns.2016.03.041

      Highlights

      • The meta-analysis is to compare intracranial aneurysms treated with SAC and BAC.
      • Complete occlusion rate at the end of the procedure is similar between SAC and BAC.
      • Complete occlusion rate is higher with SAC at 6 months or later after the procedure.
      • Overall complication rates and retreatment rates are similar between SAC and BAC.

      Abstract

      Background

      Stent-assisted coiling and balloon-assisted coiling are well-established minimally invasive techniques for treatment of intracranial aneurysms. The aim of this study was to use meta-analysis methods to compare clinical outcomes of aneurysms treated with stent-assisted coiling versus balloon-assisted coiling.

      Methods

      We searched for two-arm prospective studies and retrospective studies that compared the clinical outcomes in patients that received stent-assisted or balloon-assisted aneurysm treatment. Database search was performed through May 2015. Odds ratios (OR) with 95% confidence intervals (CI) were used to compare the clinical outcomes in patients that underwent either stent-assisted or balloon-assisted coiling for intracranial aneurysms management.

      Results

      Complete occlusion rates at the end of the coiling procedure were similar between patients that received stent-assisted and balloon-assisted aneurysm treatment (OR = 0.763, 95% CI = 0.47 to 1.23, P = 0.270). However, complete occlusion rates were higher with stent-assisted coiling at 6 months or later after the procedure (OR = 1.82, 95% CI = 1.21 to 2.74). The overall complication rates and retreatment rates in patients with recurrence were similar between stent-assisted and balloon-assisted aneurysm treatments.

      Conclusion

      Stent-assisted coiling achieved better complete occlusion rates of aneurysms at 6 months or later after the procedure compared to balloon-assisted coiling, without being associated with a higher risk of intraprocedural complications and retreatment.

      Keywords

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