ArticleBrain sciences2025
Stent-Assisted Coiling vs. Flow Diversion in Unruptured Anterior Circulation Aneurysms: A Single-Center Cohort Study.
Article in Brain sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
background and purposeStent-assisted coiling (SAC) achieves immediate aneurysm occlusion, while flow diversion (FD) promotes progressive remodeling. Comparative data in unruptured anterior circulation aneurysms remain limited.
methodsA retrospective review of our institutional database was conducted between 2021 and 2024. A total of 129 aneurysms treated with SAC (n = 33) or FD (n = 96) were identified and included in the analysis. Outcomes included angiographic occlusion, retreatment, complications, and the modified Rankin Scale (mRS). A 1:1 propensity score matching (PSM) was performed on sex, age, aneurysm size, and location (caliper 0.2, exact sex matching).
resultsA total of 130 patients (89 women, 41 men) were included in the study, with a mean age of 59.8 years (range 22-81). In the full cohort, SAC achieved higher immediate complete occlusion (62.5% vs. 8.3%,
conclusionsSAC offers rapid angiographic exclusion but at the cost of higher retreatment. FD ensures durable occlusion and absence of retreatment, with a consistent safety profile. After stratification by technical complexity, excess morbidity associated with SAC originated from anatomically demanding multistent constructs, whereas single-stent SAC showed safety comparable to FD. Age may influence periprocedural risk, particularly with SAC. These findings reinforce a tailored strategy: "Close fast with SAC, close forever with FD."
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