STAT Study

 

 

 


STENTING in the TREATMENT of LARGE, WIDE-NECKED or RECURRING INTRACRANIAL ANEURYSMS TRIAL - The STAT trial

 

Stents in the treatment of intracranial aneurysms.

Intracranial stents for the treatment of aneurysms have been introduced as adjunct tools when coiling without stenting is impossible, such as with large, recurring, or wide-necked aneurysms. These stents are of the high porosity type, different from the low porosity type know as flow diverters. Currently stents have come to enjoy a much more frequent use than originally intended, and they are often combined with coil occlusion, hopefully to reduce the rate of recurrences, a major shortcoming in the treatment of difficult aneurysms.

The main drawbacks of stenting  include:

1.      The obligatory use of antiplatelet regimens with associated morbidity per and post-procedure.

2.      The potential increased thrombotic complications despite antiplatelet therapy.

3.      The possibility of inferior coiling of the lesion because the catheter cannot move freely when introduced through the stent, when the stent is used instead of balloon assisted coil embolization.

4.      The permanent implantation of a foreign body with unknown long term consequences.

5.      The potential morbidity associated with in-stent stenosis, a well known complication of any implanted stent.

6.      Finally, the dreaded clinical consequences of abrupt parent artery occlusion despite antiplatelet therapy or when the antiplatelet regimen is stopped, for whatever reason.

 

On the more positive side, the use of stents has been associated with improved angiographic results at follow-up studies. Thus, the use of stenting is increasingly popular and many teams are now promoting stenting as a method to decrease risks of recurrence.

 

However, after many years of availability, we still lack reliable knowledge regarding the potential benefits of stenting (on long-term angiographic results) versus potential risks associated with a stent-coil strategy.

 

The STAT trial

The STAT trial has been designed to provide useful answers for the treatment of aneurysms prone to recurrence. It will compare coiling versus coiling plus stenting in patients with large aneurysms (≥10mm), recurring aneurysms after coiling (major recurrence), or wide-necked aneurysms (aspect ratio<1.5). Six hundred (600) participants will be enrolled and followed for 12 months. We hope to show that the use of stenting in addition to coiling decreases the recurrence rate from 33% to 20% at 12 months as compared to coiling alone, without an increase in associated initial or long tem deficits.
  
 
Contact Info

The STAT trial is conducted by Dr. Jean Raymond of the Centre Hospitalier de l’Université de Montréal (CHUM) as the Principal Investigator. The trial is already underway at the CHUM-Notre Dame Hospital (Montréal, Quebec).  If you are interested in joining or have any questions, please contact Dr. Raymond, the PI at jraymond.nri@gmail.com or Guylaine Gévry, the Project Manager at guylaine.gevry@crchum.qc.ca.

 

You may download the Protocol and the Case Report Forms below:

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Guylaine Gevry,
May 20, 2011, 11:24 AM
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Guylaine Gevry,
Dec 2, 2015, 11:20 AM
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Guylaine Gevry,
May 20, 2011, 11:24 AM
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