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Predictors of unfavorable outcome in stent-assisted coiling for symptomatic unruptured intracranial spontaneous vertebral artery dissecting aneurysms (uis-VADAs): results from a multicenter study.

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机构： [1]Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China [2]Department of Neurosurgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China [3]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing, China [4]Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China [5]Department of Interventional Neuroradiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China [6]Department of Neurosurgery, General Hospital of Shenyang Military Command, Shenyang, Liaoning, China [7]Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin, China [8]Department of Neurosurgery, Shandong University Qilu Hospital, Jinan, Shandong, China [9]Department of Neurosurgery, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China [10]Department of Neurosurgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China [11]Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China [12]Cerebral Vascular Disease Center, Changzhou First People’s Hospital, Changzhou, Jiangsu, China [13]Department of Neurosurgery, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China [14]Department of Neurosurgery, Yichang Central People’s Hospital, Yichang, Hubei, China [15]Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China [16]Department of Neurosurgery, Nanchang University Second Affiliated Hospital, Nanchang, Jiangxi, China [17]Department of Radiology, Henan Provincial People’s Hospital, Zhengzhou, Henan, China [18]Department of Neurosurgery, Anhui Provincial Hospital, Hefei, Anhui, China [19]Department of Neurosurgery, Shenzhen People’s Hospital, Shenzhen, Guangdong, China [20]Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China [21]Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Sichuan, China [22]Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China [23]Department of Cerebrovascular Disease, Linyi People’s Hospital, Linyi, Shandong, China [24]Department of Interventional Neuroradiology, Beijing Chaoyang Hospital, Beijing, China [25]Department of Neurosurgery, Kunming Medical College Fourth Affiliated Hospital, Kunming, Yunnan, China [26]Department of Neurosurgery, Third Military Medical University Southwest Hospital, Chongqing, China [27]Department of Neurosurgery, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China [28]Department of Neurosurgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China [29]Department of Neurosurgery, Zhongshan Hospital Fudan University, Shanghai, Shanghai, China [30]Department of Neurosurgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China [31]Department of Cerebrovascular Disease, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China [32]Department of Neurosurgery, Gansu Provincial Hospital, Lanzhou, Gansu, China [33]Department of Neurosurgery, Changhai Hospital，Naval Medical University, Shanghai, China

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To evaluate predictors of unfavorable outcome in stent-assisted coiling for symptomatic unruptured intracranial spontaneous vertebral artery dissecting aneurysms (uis-VADAs) based on 608 reconstructed lesions in 30 medical centres.A total of 608 patients (male:female=479:129; mean age, 53.26±10.26 years) with 608 symptomatic uis-VADAs underwent reconstructive treatments using stent(s) with coils between January 2009 and December 2015. Treatments and predictors of unfavorable outcomes were retrospectively analyzed.Mainly, three methods were used to treat patients with uis-VADAs, including routine single-stent in 208 patients (such as Enterprise and others), new low-profile LVIS single stent in 107 patients, and multiple stents in 293 patients. During the median 66 months of clinical follow-up, 14 patients died, and 16 of the remaining 594 survivors had unfavorable outcomes (modified Rankin Scale score 3-5). The overall mortality rate was 2.3% (14/608), and the unfavorable outcome (mRS score 3-6) rate was 4.9% (30/608). Multivariate logistic regression analysis indicated that preprocedural ischemic infarctions (OR=3.78; 95% CI 1.52 to 9.40; p<0.01), diabetes mellitus (OR=3.74; 95% CI 1.31 to 10.68; p=0.01), and procedural complications (OR=14.18; 95% CI 5.47 to 36.80; p<0.01) were predictors of unfavorable outcome in the reconstructed VADAs.This multicenter study indicated that preprocedural ischemic infarctions, diabetes mellitus, and procedural complications were related to unfavorable clinical outcomes in the reconstructed uis-VADAs.© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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大类 | 1 区

医学

小类 | 1 区神经成像 1 区外科

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大类 | 1 区

医学

小类 | 1 区神经成像 1 区外科

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Q1 NEUROIMAGING Q1 SURGERY

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Q1 NEUROIMAGING Q1 SURGERY

影响因子： 4.5 最新[2023版] 4.7 最新五年平均 8.572 出版当年[2021版] 6.024 出版当年五年平均 5.836 出版前一年[2020版] 4.9 出版后一年[2022版]

第一作者：

第一作者机构： [1]Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China [2]Department of Neurosurgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China

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通讯作者：

通讯机构： [1]Neurovascular Center, Changhai Hospital，Naval Medical University, Shanghai, China [3]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing, China [4]Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China [*1]Neurovascular Centre, Changhai Hospital, Shanghai, China

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