PMID- 27073908
OWN - NLM
STAT- MEDLINE
DCOM- 20160830
LR  - 20190219
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 11
IP  - 4
DP  - 2016
TI  - Closed-Cell Stent-Assisted Coiling of Intracranial Aneurysms: Evaluation of 
      Changes in Vascular Geometry Using Digital Subtraction Angiography.
PG  - e0153403
LID - 10.1371/journal.pone.0153403 [doi]
LID - e0153403
AB  - BACKGROUND: Stent-assisted coil embolization (SACE) plays an important role in 
      the treatment of intracranial aneurysms. The purpose of this study was to 
      investigate geometrical changes caused by closed-cell design stents in 
      bifurcation and sidewall aneurysms. METHODS: 31 patients with 34 aneurysms 
      underwent SACE with closed-cell design stents. Inflow angle alpha, determined by 
      aneurysm neck and afferent vessel, and angle between afferent and efferent vessel 
      close to (delta1), respectively, more remote from the aneurysm neck (delta2) were 
      graphically determined in 2D angiography projections. RESULTS: Stent assisted 
      coiling resulted in a significant increase of all three angles from a mean value 
      (+/-SEM) of alpha = 119 degrees  (+/-6.5 degrees ) pretreatment to 130 degrees  (+/-6.6 degrees ) posttreatment (P </= .001), 
      delta1 = 129 degrees  (+/-6.4 degrees ) to 139 degrees  (+/-6.1 degrees ), (P </= .001) and delta2 = 115 degrees  (+/-8.4 degrees ) to 126 degrees  
      (+/-7.5 degrees ), (P </= .01). Angular change of delta1 in AcomA aneurysms was significant 
      greater compared to sidewall aneurysms (26 degrees +/-4.9 degrees  versus 8 degrees +/- 2.3 degrees , P </= .05). The 
      initial angle of delta1 and delta2 revealed a significantly inverse relationship to the 
      angle increase (delta1: r = -0.41, P </= .05 and delta2: r = -0.47, P </= .01). Moreover, 
      angle delta1 was significantly higher in unruptured compared to ruptured aneurysms 
      (135 degrees +/-7.1 degrees  versus 103 degrees +/-10.8 degrees , P </= .05). CONCLUSION: Stent deployment modulates 
      the geometry of the aneurysm-vessel complex, which may lead to favorable 
      hemodynamic changes more similar to unruptured than to ruptured aneurysms. Our 
      findings also suggest that the more acute-angled aneurysm-vessel anatomy, the 
      larger the angular change. Further studies are needed to investigate whether 
      these changes improve the clinical outcome.
FAU - Beller, Ebba
AU  - Beller E
AD  - Abteilung fur Diagnostische und Interventionelle Neuroradiologie, Klinikum rechts 
      der Isar, Technische Universitat Munchen, Munich, Germany.
FAU - Klopp, David
AU  - Klopp D
AD  - Acandis GmbH & Co. KG, Pforzheim, Germany.
FAU - Gottler, Jens
AU  - Gottler J
AD  - Abteilung fur Diagnostische und Interventionelle Neuroradiologie, Klinikum rechts 
      der Isar, Technische Universitat Munchen, Munich, Germany.
FAU - Kaesmacher, Johannes
AU  - Kaesmacher J
AD  - Abteilung fur Diagnostische und Interventionelle Neuroradiologie, Klinikum rechts 
      der Isar, Technische Universitat Munchen, Munich, Germany.
FAU - Zimmer, Claus
AU  - Zimmer C
AD  - Abteilung fur Diagnostische und Interventionelle Neuroradiologie, Klinikum rechts 
      der Isar, Technische Universitat Munchen, Munich, Germany.
FAU - Kirschke, Jan S
AU  - Kirschke JS
AD  - Abteilung fur Diagnostische und Interventionelle Neuroradiologie, Klinikum rechts 
      der Isar, Technische Universitat Munchen, Munich, Germany.
FAU - Prothmann, Sascha
AU  - Prothmann S
AD  - Abteilung fur Diagnostische und Interventionelle Neuroradiologie, Klinikum rechts 
      der Isar, Technische Universitat Munchen, Munich, Germany.
LA  - eng
PT  - Journal Article
DEP - 20160413
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Angiography, Digital Subtraction
MH  - *Cerebral Angiography
MH  - Embolization, Therapeutic/*methods
MH  - Female
MH  - Humans
MH  - Intracranial Aneurysm/diagnostic imaging/*therapy
MH  - Male
MH  - Middle Aged
MH  - *Stents
MH  - Treatment Outcome
PMC - PMC4830582
COIS- Competing Interests: Mr. Klopp is employed by Acandis GmbH & Co. KG, Pforzheim, 
      Germany. This does not alter the authors' adherence to PLOS ONE policies on 
      sharing data and materials. The other authors have no conflict of interest.
EDAT- 2016/04/14 06:00
MHDA- 2016/08/31 06:00
PMCR- 2016/04/13
CRDT- 2016/04/14 06:00
PHST- 2016/01/18 00:00 [received]
PHST- 2016/03/29 00:00 [accepted]
PHST- 2016/04/14 06:00 [entrez]
PHST- 2016/04/14 06:00 [pubmed]
PHST- 2016/08/31 06:00 [medline]
PHST- 2016/04/13 00:00 [pmc-release]
AID - PONE-D-16-02335 [pii]
AID - 10.1371/journal.pone.0153403 [doi]
PST - epublish
SO  - PLoS One. 2016 Apr 13;11(4):e0153403. doi: 10.1371/journal.pone.0153403. 
      eCollection 2016.