Abstract 387: Readmissions and retreatment among stent‐assisted endovascular coiling patients with unruptured intracranial aneurysm using ENTERPRISE®2 Stent versus LVIS™Stent

Introduction Stent‐assisted endovascular coiling is a safe and effective method for treating wide‐necked unruptured intracranial aneurysm (UIA), which allows for increase in volumetric filling, prevents coil prolapse, and promotes aneurysm thrombosis. The objective of this study was to examine differences in 180‐day inpatient readmissions and retreatment among UIA patients treated with the laser cut nitinol ENTERPRISE® 2 stent versus the braided nitinol LVIS™ stent during endovascular stent assisted coiling procedure. Methods Using a U.S. nationwide hospital database, PINC AI Healthcare Database (PHD), UIA patients aged ≥18 years undergoing endovascular coiling procedures were identified and classified into ENTERPRISE® 2 and LVIS™ cohorts based on the stent used. Study outcomes, including 180‐day all‐cause and UIA‐related inpatient readmissions, and UIA‐related retreatment, were compared between the two groups. Inverse probability of treatment weighting of propensity score approach was used to balance covariates (i.e. patient demographic, comorbidity, and hospital characteristics) between the two cohorts. A weighted generalized estimating equation (GEE) model was used to assess outcomes among the weighted ENTERPRISE® 2 and LVIS™ cohorts. Results Based on study inclusion and exclusion criteria, 249 patients were identified, with 130 in the ENTERPRISE® 2 cohort and 119 in the LVIS™ cohort. Baseline patient characteristics were well balanced after weighting. Patients undergoing endovascular stent assisted coiling procedures using ENTERPRISE® 2 had significantly lower rates of 180‐day all‐cause inpatient readmissions compared to those treated with LVIS™ (9.1% vs 24.3%, p =0.016; odds ratio [OR]: 0.31, 95% confidence interval [CI]: 0.12‐0.82, p =0.018). Bivariate analysis revealed a significantly lower rate of 180‐day UIA‐specific inpatient readmission among the ENTERPRISE® 2 cohort versus the LVIS™ cohort (2.6% vs 12.4%, p =0.036); however, this difference was not significant in GEE analysis (OR: 0.19, 95% CI: 0.03‐1.04, p =0.056). No significant difference was observed for 180‐day UIA‐related retreatment among the study cohorts (ENTERPRISE® 2 vs LVIS™: 2.6% vs 11.6%, p =0.056; OR: 0.20, 95% CI: 0.03‐1.20, p =0.079). Conclusions: Patients who were treated with the laser cut ENTERPRISE®2 stent during endovascular coiling were observed to have significantly lower risk of all‐cause and UIA‐related inpatient readmissions compared to those treated with the braided LVIS™ stent. The laser cut form of the ENTERPRISE®2 stent may allow for high strut tension and compression strength making it less likely to be prone to deformation as compared to a braided stent like the LVIS™, which may be associated with the observed differences in readmission rates among the two stents.