Coiling embolization strategy for medium-to-giant-sized intracranial aneurysms treated with pipeline embolization device: a propensity score-weighted study

Objectives We aim to investigate associations between different coil strategies and outcomes in the aneurysms treated by a pipeline embolization device (PED). Methods Patients with medium-to-giant-sized aneurysms treated by PED were included. The total cohort was divided into PED-alone and PED-coili...

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Published in:European radiology 2023-11, Vol.33 (11), p.7967-7977
Main Authors: Tong, Xin, Han, Mingyang, Xue, Xiaopeng, Wu, Zhongxue, Chen, Jigang, Liu, Aihua
Format: Article
Language:English
Subjects:
Aneurysm
Aneurysms
Angiography, Digital Subtraction
Blood Vessel Prosthesis
Diagnostic Radiology
Effectiveness
Embolization
Embolization, Therapeutic - methods
Endovascular coiling
Head and Neck
Humans
Imaging
Internal Medicine
Interventional Radiology
Intracranial Aneurysm - surgery
Intracranial Aneurysm - therapy
Medicine
Medicine & Public Health
Multivariate analysis
Neuroradiology
Occlusion
Packing
Patients
Propensity Score
Radiology
Retrospective Studies
Subgroups
Treatment Outcome
Ultrasound
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Summary:Objectives We aim to investigate associations between different coil strategies and outcomes in the aneurysms treated by a pipeline embolization device (PED). Methods Patients with medium-to-giant-sized aneurysms treated by PED were included. The total cohort was divided into PED-alone and PED-coiling groups, and the PED-coiling group was further divided into loose and dense packing subgroups. Multivariate logistic analyses and stabilized inverse probability of treatment weighting (sIPTW) were performed to investigate the relationships between coiling strategies and outcomes. Restricted cubic spline (RCS) curves were used to describe the coiling degree and angiographic outcome relationship. Results A total of 398 patients with 410 aneurysms were included. Aneurysms treated with PED coiling had a lower incomplete occlusion rate (15.3% vs. 30.3%, p  = 0.002), higher total perioperative complication rate (14.2% vs. 3.5%, p  = 0.001), longer production time (142.14 min vs. 101.26 min, p  
ISSN:1432-1084
0938-7994
1432-1084
DOI:10.1007/s00330-023-09800-z