The preliminary clinical application research on side branch protection technique in single stent-assisted coiling embolization for the treatment of intracranial acute-angulated absolute wide neck bifurcation aneurysm
10.3760/cma.j.cn112149-20250213-00078
- VernacularTitle:边支保护技术在单支架辅助弹簧圈栓塞颅内分叉处锐角型绝对宽颈动脉瘤中的临床应用
- Author:
Huabiao ZHANG
1
;
Benjun ZHANG
;
Bo MA
;
Pengli ZHOU
;
Song ZHANG
;
Zhanguo SUN
;
Yanan ZHAO
;
Xinwei HAN
Author Information
1. 郑州大学第一附属医院放射介入科，郑州 450052
- Publication Type:Journal Article
- Keywords:
Intracranial aneurysm;
Radiography, interventional;
Embolization, therapeutic;
Stents;
Acute-angulated absolute wide neck bifurcation aneurysm
- From:
Chinese Journal of Radiology
2025;59(4):441-446
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the preliminary clinical application efficacy of the side branch protection (SBP) technique in single stent-assisted coiling (SSAC) for the treatment of intracranial acute-angulated absolute wide neck bifurcation aneurysms (aWNBA).Methods:The clinical data of 23 patients with aWNBA treated at the Department of Interventional Medicine of the First Affiliated Hospital of Zhengzhou University from January 2013 to June 2024 were retrospectively collected. Patients were divided into two groups based on the stent type used: 11 in the side branch protection (SBP) group and 12 in the double stent-assisted coiling (DSAC) group. The characteristics of aWNBA including the size, the first and second angles between side branches and main artery, and the diameter of aneurysm, were analyzed preoperatively. Stent thromboembolism was recorded during the operation, and Raymond-Roy Occlusion Classification (RROC) and the modified Rankin Scale (mRS) were used to evaluate the treatment efficacy postoperatively. During the follow-up period the RROC and mRS were reevaluated and the stent stenosis was recorded. Mann-Whitney U test was used to compare the two groups′ data of skewed distribution, χ2 test and Fisher′s exact test were used to compare the two groups′ categorical data. Results:The 23 patients with aWNBA included 11 with aneurysms at the bifurcation of the middle cerebral artery, 6 at the top of the basilar artery, and 6 at the bifurcation of the anterior communicating artery. There was no statistically significant difference between the two groups in terms of aWNBA basic characteristics before operation (all P>0.05). The SBP group had a lower incidence of intraoperative stent thromboembolism and a lower mRS postoperatively compared to DSAC group (all P<0.05); meanwhile, there was no statistically significant difference between two groups on RROC after the operation ( P=0.949). During the follow-up period, the SBP group had lower rates of stent stenosis and mRS compared to the DSAC group (all P<0.05) and there was no statistically significant difference between two groups in RROC ( P=0.527). Conclusions:In cases of dense coiling on aWNBA, the SBP technique in SSAC is able to reduce incidence of the stent thromboembolism, stent stenosis as well as neurological injury; therefore, it is a safe and feasible therapeutic strategy for the aWNBA.
