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Two-center experience with Neuroform Atlas stent-assisted coil occlusion of broad-based intracranial aneurysms

  • Interventional Neuroradiology
  • Published:
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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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Correspondence to Sebastian Fischer.

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Conflict of interest

The authors declare that they have no conflict of interest related to this study.

Author 1 none.

Author 2 none.

Author 3 agreement with Stryker for proctoring services and consulting.

Author 4 agreement with Stryker for proctoring services and consulting.

Author 5 agreement with Stryker for proctoring services and consulting.

Author 6 agreement with Stryker for proctoring services and consulting.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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A separate informed consent from each patient before inclusion in this study was not required due to the retrospective design of the study.

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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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