PMID- 30158353
OWN - NLM
STAT- MEDLINE
DCOM- 20190207
LR  - 20190215
IS  - 1349-8029 (Electronic)
IS  - 0470-8105 (Print)
IS  - 0470-8105 (Linking)
VI  - 58
IP  - 10
DP  - 2018 Oct 15
TI  - Evaluation of Acute In-stent Thrombosis during Stent-assisted Coil Embolization 
      of Unruptured Intracranial Aneurysms.
PG  - 435-441
LID - 10.2176/nmc.oa.2018-0131 [doi]
AB  - Stent-assisted coil embolization (SACE) is used to address wide-necked or complex 
      aneurysms. However, periprocedural and/or late in-stent thrombosis (IST) elicit 
      neurological events. We investigated the incidence and timed the development of 
      acute IST during SACE with braided- or laser-cut stents in a retrospective study. 
      Between May 2013 and April 2018, we evaluated 11 ISTs that occurred in the course 
      of 185 SACE procedures (self-expandable laser-cut stent, n = 128; braided stent, 
      n = 57). The onset of IST was measured from the time of stent placement. All 11 
      patients with IST were treated with anticoagulants and underwent hypertension 
      induction. Post-procedural neurological events due to IST were also recorded. The 
      implantation of a laser-cut stent elicited IST in 5 of 128 patients (3.9%); 
      braided stent placements resulted in IST in 6 of 57 patients (10.5%) (P = 0.1). 
      The mean stent diameter was significantly smaller in patients with-IST than 
      without IST (3.0 +/- 0.9 mm vs. 4.5 +/- 0.7 mm, P = 0.007). The mean interval between 
      stent placement and IST onset was 19 +/- 7.7 min; it was significantly earlier for 
      braided- than laser-cut stents (17.5 +/- 4.1 min vs. 29.0 +/- 4.8 min, P = 0.006). 
      All ISTs were resolved during the procedure. Three patients experienced 
      postoperative neurologic events. We recommend the meticulous and prolonged 
      monitoring of images after stent placement because delayed intraoperative IST can 
      occur especially when laser-cut stents are used.
FAU - Nii, Kouhei
AU  - Nii K
AD  - Department of Neurosurgery, Fukuoka University Chikushi Hospital.
FAU - Inoue, Ritsurou
AU  - Inoue R
AD  - Department of Neurosurgery, Fukuoka University Chikushi Hospital.
FAU - Morinaga, Yusuke
AU  - Morinaga Y
AD  - Department of Neurosurgery, Fukuoka University Chikushi Hospital.
FAU - Mitsutake, Takafumi
AU  - Mitsutake T
AD  - Department of Neurosurgery, Fukuoka University Chikushi Hospital.
FAU - Hanada, Hayatsura
AU  - Hanada H
AD  - Department of Neurosurgery, Fukuoka University Chikushi Hospital.
LA  - eng
PT  - Journal Article
DEP - 20180830
PL  - Japan
TA  - Neurol Med Chir (Tokyo)
JT  - Neurologia medico-chirurgica
JID - 0400775
SB  - IM
MH  - Aged
MH  - Blood Vessel Prosthesis Implantation/*adverse effects
MH  - Embolization, Therapeutic/*adverse effects
MH  - Female
MH  - Graft Occlusion, Vascular/diagnosis/*etiology/therapy
MH  - Humans
MH  - Intracranial Aneurysm/*therapy
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Stents/*adverse effects
MH  - Thrombosis/diagnosis/*etiology/therapy
PMC - PMC6186760
OTO - NOTNLM
OT  - complication
OT  - in-stent thrombosis
OT  - intracranial aneurysm
OT  - stent-assisted coil embolization
COIS- Conflicts of Interest Disclosure The authors have no personal financial or 
      institutional interest in any of the drugs, materials, or devices used in this 
      study. All authors are members of The Japan Neurosurgical Society and all have 
      registered self-reported COI Disclosure Statement Forms on-line.
EDAT- 2018/08/31 06:00
MHDA- 2019/02/08 06:00
PMCR- 2018/10/01
CRDT- 2018/08/31 06:00
PHST- 2018/08/31 06:00 [pubmed]
PHST- 2019/02/08 06:00 [medline]
PHST- 2018/08/31 06:00 [entrez]
PHST- 2018/10/01 00:00 [pmc-release]
AID - nmc-58-435 [pii]
AID - 10.2176/nmc.oa.2018-0131 [doi]
PST - ppublish
SO  - Neurol Med Chir (Tokyo). 2018 Oct 15;58(10):435-441. doi: 
      10.2176/nmc.oa.2018-0131. Epub 2018 Aug 30.