Abstract
Purpose
Stent-assisted coiling (SAC) represents an established treatment option for broad-based intracranial aneurysms. Here we report our initial and follow-up experience with the Neuroform Atlas Stent, a hybrid open- and closed-cell low-profile stent in the treatment of broad-based aneurysms.
Methods
All intracranial aneurysms treated by SAC with the intention to apply the Neuroform Atlas Stent between July 2015 and December 2019 were included. Angiographic and clinical results were analyzed including all follow-up examinations.
Results
A total of 119 aneurysms (8 acutely ruptured) in 112 patients were included. In 19 cases (16.0%) re-catheterization of the aneurysm was performed in a second procedure after failure to re-cross the stent initially. Of all aneurysms, 83.2% (99/119) were completely occluded following the procedure. In 75.6% of all cases (90/119), a single microcatheter was used for both, implantation of the stent and coil occlusion of the aneurysm. At 3–6 and 12 months follow-up, the complete occlusion rates were 75.2 (79/105) and 81.3% (74/91). The thromboembolic (stent thrombosis) and hemorrhagic complication rate was 1.7 (2/119) and 0.8% (1/119), respectively, resulting in a procedure-related morbidity and mortality rate of 0.9 and 0.9% (1/112 patients).
Conclusion
SAC using the Neuroform Atlas Stent offers a safe and effective option to treat broad-based intracranial aneurysms with a high angiographic and clinical success rate. In the majority of procedures, the application of two mircocatheters is not required. Prospective comparative studies might help to identify the value of SAC using the Neuroform Atlas Stent among the growing treatment options for broad-based aneurysms.
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Abbreviations
- SAC:
-
stent-assisted coiling
- FDA:
-
Food and Drug Administration
- mRS:
-
modified Rankin score
- RROC:
-
Raymond-Roy Occlusion Classification
- A com:
-
anterior communicating artery
- ACA:
-
anterior cerebral artery
- ACA A1:
-
pre-communicating segment of ACA
- ACA A2:
-
post-communicating segment of ACA
- MCA bif:
-
middle cerebral artery bifurcation
- M1:
-
proximal segment of the MCA
- M2:
-
post bifurcation segment of the MCA
- BA tip:
-
basilar artery tip
- BA tr:
-
basilar artery trunk
- PCA:
-
posterior cerebral artery
- PICA:
-
posterior inferior cerebellar artery
- ICA:
-
internal carotid artery ophthalmic segment
- ICA bif:
-
internal carotid artery bifurcation segment
- ICA P com:
-
internal carotid artery posterior communicating segment
- SAH:
-
subarachnoid hemorrhage
- ACT:
-
activated clotting time
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Arslan, G., Maus, V., Weber, W. et al. Two-center experience with Neuroform Atlas stent-assisted coil occlusion of broad-based intracranial aneurysms. Neuroradiology 63, 1093–1101 (2021). https://doi.org/10.1007/s00234-020-02602-w
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DOI: https://doi.org/10.1007/s00234-020-02602-w