Purpose
Wide-necked intracranial aneurysms therapy remains a challenge for neuro interventionalists,
mainly for the high recurrence rate. Different techniques and devices can be used to treat such complex lesions (flow-diverter, intra-saccular devices, balloon-remodeling).
We report mid-term follow-up, with clinical and angiographic results, of Neuroform Atlas stent-assisted coiling.
Methods and materials
Patient population
In this retrospective single-center study, 32 patients with 33 aneurysms treated from November 2015 to April 2019 for wide-necked unruptured intracranial aneurysms using the low profile Neuroform Atlas stent-assisted coiling were included.
Antiplatelet therapy
All patients underwent dual antiplatelet-therapy 7 days before the endovascular procedure with aspirin (100 mg) and clopidogrel (75 mg). After stent placement, double antiplatelet therapy has been continued for 3-6 months. Aspirin 100 mg was given until the 6th month.
Technique
All procedures were performed under general anesthesia; a...
Results
Patients and aneurysms characteristics
Our study included 32 patients (22 females; 10 males) with 33 unruptured aneurysms, treated with the Neuroform Atlas stent. The mean age was 59 years old (range from 31 to 78). Eight patients had a recurrence from a previous treatment; four from an urgent endovascular treatment, performed for subarachnoid hemorrhage, and four from previous ordinary treatment (3 simple coilings and 1 surgical clipping).
Aneurysms were located in the anterior circulation in 29 cases (19 anterior communicating artery – AcoA, 6 in...
Conclusion
Wide necked cerebral aneurysms remain a challenge for neurointerventionalists, considering their high recurrence rate and potential coils migration.
The stent-assisted coiling technique has significantly improved the results in terms of aneurysmal sac occlusion and morbidity rate [2,3].
In our experience the Neuroform Atlas stent assisted-coiling has shown to be a safe and effective technique for the treatment of wide-necked intracranial aneurysms with encouraging clinical and angiographic results.
Personal information and conflict of interest
A. Romi; Rome/IT - nothing to disclose A. Pedicelli; ROMA (RM)/IT - nothing to disclose A. Alexandre; Rome/IT - nothing to disclose I. Valente; Rome/IT - nothing to disclose E. Lozupone; Rome/IT - nothing to disclose F. D'argento; Taviano (LE)/IT - nothing to disclose C. Colosimo; Rome/IT - nothing to disclose
References
[1] Mascitelli J et al. An update to the Raymond–Roy Occlusion Classification of intracranial aneurysms treated with coil embolization. J NeuroIntervent Surg 2015;7:496–502
[2] Geyik S, Yavus K, Yurttutan N, et al. Stent-assisted coiling in endovascular treatment of 500 consecutive cerebral aneurysm with long-term follow-up. AJNR Am J Neuroradiol 2013;34:2157-62
[3] Goertz L, Dorn F, Siebert E, Herzberg M, Borggrefe J, Schlamann M, Krischek B, Stavrinou P, Mpotsaris A, Bohner G, Liebig T, Kabbasch C. Safety and efficacy of the Neuroform Atlas for stent-assisted coiling...