The low-profile Neuroform Atlas stent in the treatment of wide-necked intracranial aneurysms – immediate and midterm results: An Italian multicenter registry

Autor: Andrea Alexandre, Antonio Pitrone, Emiliano Visconti, Rosario Papa, Antonio Armando Caragliano, Maria Ruggiero, Angela Alibrandi, Dario Luca Lauretti, Nicola Limbucci, Sergio Nappini, Agostino Tessitore, Nicola Cavasin, Marcello Longo, Sergio Vinci, Roberto Menozzi
Rok vydání: 2020
Předmět:
Adult
Male
Wide-necked aneurysm
medicine.medical_specialty
Computed Tomography Angiography
Low-profile stent
Neuroform Atlas stent
Stent assisted-coiling
medicine.medical_treatment
Stent assisted coiling
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Aneurysm
Atlas (anatomy)
Occlusion
medicine
Humans
Radiology
Nuclear Medicine and imaging
Registries
cardiovascular diseases
Aged
Retrospective Studies
Aged
80 and over
Radiological and Ultrasound Technology
business.industry
Angiography
Digital Subtraction
Stent
Intracranial Aneurysm
Middle Aged
medicine.disease
Embolization
Therapeutic
Cerebral Angiography
medicine.anatomical_structure
Italy
Wide necked aneurysm
Female
Stents
Neurology (clinical)
Cerebral tissue
Radiology
business
Magnetic Resonance Angiography
Platelet Aggregation Inhibitors
030217 neurology & neurosurgery
High recurrence rate
Zdroj: Journal of Neuroradiology. 47:421-427
ISSN: 0150-9861
DOI: 10.1016/j.neurad.2019.03.005
Popis: Background and purpose Wide-necked brain aneurysms therapy remains a challenge for neurointerventionalists, mainly for the high recurrence rate. Low-profile stents make feasible the treatment of these aneurysms. In our multicenter series we analyzed clinical and angiographic results of Neuroform Atlas stent-assisted coiling. Materials and methods From January 2016 to March 2017, 113 wide-necked aneurysms were discovered with CTA, MRA and DSA. The Atlas stent-assisted coiling procedures were performed under general anesthesia with sequential or jailing techniques. Six months follow-up DSA was performed to assess the recurrence rate through the modified Raymond-Roy occlusion scale (RROC). Moreover, patients were evaluated clinically to analyse the degree of disability according to the mRS. MRI was performed at 12 months evaluating both the cerebral tissue and the vessels. Results In all the procedures it was feasible to navigate the Neuroform Atlas to the goal vessel and deploy the stent across the aneurysmal neck. Intra-procedural complications account for the 6.2% (7/113). The immediate occlusion rate was RROC 1 in 88%, 2 in 9% and 3 in 3% of cases. The 6 months clinical data showed mRS Score 0–1 in 96.5% of patients; 3 patients died of complications related to SAH. The 12 months follow-up showed RROC of 1 in 82%, 2 in 13% and 3 in 5% of cases. No aneurysm has been retreated. Conclusions In our multicenter 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.
Databáze: OpenAIRE
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