{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T17:23:38Z","timestamp":1758043418579,"version":"3.44.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Flow diverter stent (FDS) deployment with coil embolization (CE) achieves high aneurysmal occlusion rates. However, no established guidelines exist for the optimal packing density (PD) when treating large or giant aneurysms. This study aimed to investigate the optimal PD in FDS deployment with CE.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">This retrospective multicenter study involved 97 consecutive patients with unruptured large or giant (\u2265 10\u00a0mm) aneurysms treated with FDS deployment alone or with FDS and CE, between August 2019 and December 2023. We calculated the volume embolization ratio as the coil PD using Angiosuite Neuro Edition ver. 10.03. We defined O'Kelly\u2013Marotta grading scale D as complete obliteration (CO) at 6 months after deployment and analyzed the associations between the PD and aneurysmal CO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Seventeen patients (means \u00b1 SD age, 53.8\u00b19.94 years; 14 [82.4%] female patients) in the FDS with CE group, and 18 patients (63.6\u00b112.4 years; 14 [77.8%] female patients) in the FDS alone group were included for analysis. CO was achieved in 14 (82.3%) patients in the FDS with CE group and 9 (50.0%) in the FDS alone group (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              = 0.08). volume embolization ratio (\u2265 8.9%) was significantly associated with CO in the univariable analysis (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              = 0.01; odds ratio: 14.3 [95% CI: 1.57\u2013129.9]) and the multivariable analysis (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              = 0.02; odds ratio, 10.5 [95% CI: 1.09\u2013100.7]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">It may be unnecessary to continue CE after the PD has reached 8.9% volume embolization ratio when treating large or giant intracranial aneurysms with combined FDS and CE.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.125.001751","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T07:05:29Z","timestamp":1751526329000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Optimal Coil Packing Density for Aneurysmal Complete Obliteration in Flow Diversion Stenting: A Retrospective Study"],"prefix":"10.1161","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-838X","authenticated-orcid":false,"given":"Ryosuke","family":"Maeoka","sequence":"first","affiliation":[{"name":"Nara Medical University","place":["Nara, Japan"]},{"name":"Ohnishi Neurological Center","place":["Hyogo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Ohnishi","sequence":"additional","affiliation":[{"name":"Ohnishi Neurological Center","place":["Hyogo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shohei","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Nara Medical University","place":["Nara, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Kotsugi","sequence":"additional","affiliation":[{"name":"Nara Medical University","place":["Nara, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosuke","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Nara Medical University","place":["Nara, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuichi","family":"Yamada","sequence":"additional","affiliation":[{"name":"Nara Medical University","place":["Nara, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiro","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Nara Medical University","place":["Nara, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1001\/jamaneurol.2016.0609","article-title":"Flow diversion for the treatment of intracranial aneurysms","volume":"73","author":"Walcott BP","year":"2016","unstructured":"Walcott BP, Stapleton CJ, Choudhri O, Patel AB. Flow diversion for the treatment of intracranial aneurysms. JAMA Neurol. 2016;73:1002\u20101008. https:\/\/doi.org\/10.1001\/jamaneurol.2016.0609","journal-title":"JAMA Neurol"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.113.001785"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2014-011475"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2421"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2727"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2021-018361"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2015.06.018"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1177\/159101991001600204","article-title":"A novel grading scale for the angiographic assessment of intracranial aneurysms treated using flow diverting stents","volume":"16","author":"O'kelly C","year":"2010","unstructured":"O'kelly C, Krings T, Fiorella D, Marotta TR. A novel grading scale for the angiographic assessment of intracranial aneurysms treated using flow diverting stents. Interv Neuroradiol. 2010;16:133\u2010137. https:\/\/doi.org\/10.1177\/159101991001600204","journal-title":"Interv Neuroradiol"},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","first-page":"256","DOI":"10.3171\/2018.2.JNS1836","article-title":"Editorial. Indication and technique for using the pipeline embolization device to treat intracranial aneurysms","volume":"130","author":"Burkhardt J\u2010K","year":"2018","unstructured":"Burkhardt J\u2010K, Tanweer O, Nelson PK, Riina HA. Editorial. Indication and technique for using the pipeline embolization device to treat intracranial aneurysms. J Neurosurg. 2018;130:256\u2010258. https:\/\/doi.org\/10.3171\/2018.2.Jns1836","journal-title":"J Neurosurg"},{"key":"e_1_3_2_11_2","first-page":"762","article-title":"Evaluation of the stability of aneurysms after embolization using detachable coils: correlation between stability of aneurysms and embolized volume of aneurysms","volume":"23","author":"Tamatani S","year":"2002","unstructured":"Tamatani S, Ito Y, Abe H, Koike T, Takeuchi S, Tanaka R. Evaluation of the stability of aneurysms after embolization using detachable coils: correlation between stability of aneurysms and embolized volume of aneurysms. AJNR Am J Neuroradiol. 2002;23:762\u2010767.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A0649"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000325497.79690.4C"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3171\/2015.7.JNS15582"},{"key":"e_1_3_2_15_2","doi-asserted-by":"crossref","DOI":"10.1177\/1756286420967828","article-title":"Pipeline embolization device for intracranial aneurysms in a large Chinese cohort: Factors related to aneurysm occlusion","volume":"13","author":"Luo B","year":"2020","unstructured":"Luo B, Kang H, Zhang H, Li T, Liu J, Song D, Zhao Y, Guan S, Maimaitili A, Wang Y, et\u00a0al. Pipeline embolization device for intracranial aneurysms in a large Chinese cohort: Factors related to aneurysm occlusion. Ther Adv Neurol Disord. 2020;13:1756286420967828. https:\/\/doi.org\/10.1177\/1756286420967828","journal-title":"Ther Adv Neurol Disord"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000000579"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3171\/2017.3.FOCUS1749"},{"key":"e_1_3_2_18_2","doi-asserted-by":"crossref","first-page":"E1215","DOI":"10.1227\/01.NEU.0000369194.13994.62","article-title":"Delayed cranial nerve palsy after coiling of carotid cavernous sinus aneurysms: case report","volume":"66","author":"Xu DS","year":"2010","unstructured":"Xu DS, Hurley MC, Batjer HH, Bendok BR. Delayed cranial nerve palsy after coiling of carotid cavernous sinus aneurysms: case report. Neurosurgery. 2010;66:E1215\u2010E1216. https:\/\/doi.org\/10.1227\/01.NEU.0000369194.13994.62","journal-title":"Neurosurgery"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2022-019202"},{"key":"e_1_3_2_20_2","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.3389\/fneur.2019.01191","article-title":"Variation of mass effect after using a flow diverter with adjunctive coil embolization for symptomatic unruptured large and giant intracranial aneurysms","volume":"10","author":"Wang Z","year":"2019","unstructured":"Wang Z, Tian Z, Li W, Wang J, Zhu W, Zhang M, Zhang Y, Liu J, Wang K, Zhang Y, et\u00a0al. Variation of mass effect after using a flow diverter with adjunctive coil embolization for symptomatic unruptured large and giant intracranial aneurysms. Front Neurol. 2019;10:1191. https:\/\/doi.org\/10.3389\/fneur.2019.01191","journal-title":"Front Neurol"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.3171\/2014.12.JNS141259"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4678"}],"container-title":["Stroke: Vascular and Interventional Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/SVIN.125.001751","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T06:08:55Z","timestamp":1757657335000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/SVIN.125.001751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1161\/SVIN.125.001751"],"URL":"https:\/\/doi.org\/10.1161\/svin.125.001751","relation":{},"ISSN":["2694-5746"],"issn-type":[{"type":"electronic","value":"2694-5746"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-01-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e001751"}}