Low-Profile Neuroform Atlas Stent-Assisted Coiling of Intracranial Aneurysms: Single-Center Initial Experience

Abstract

Background Neuroform Atlas stent is a relatively new device used for stent-assisted coiling (SAC) of wide-necked intracranial aneurysms.

Purpose To elaborate the initial experience in a single center to assess the efficacy and initial results of Neuroform Atlas for SAC of intracranial aneurysms.

Methods Between February 2017 and September 2018, eight patients (five females, three males; mean age 56 years) underwent SAC with Neuroform Atlas.

Results Five unruptured and three ruptured wide-necked aneurysms were treated with Neuroform Atlas SAC. Immediate complete occlusion modified Roy-Raymond class 1 (MRRC 1) or mild neck residue class 2 (MRRC 2) was achieved in three patients and five other patients had minimal residual interstitial filling of the aneurysm (MRRC 3b). One patient with ruptured intracranial aneurysm succumbed to the illness in the first postoperative day due to massive rebleed. Other seven patients remained clinically asymptomatic in the follow-up period. Patent stent was noted at three to seven months follow-up magnetic resonance angiography (MRA) in five patients. Complete occlusion of the aneurysm was noted in three patients, and minimal residual aneurysm was seen in two patients.

Conclusion Neuroform Atlas stent is safe and effective in achieving good angiographic outcome in complex intracranial aneurysms.

Keywords

intracranial aneurysms - low-profile stent - Neuroform Atlas stent

• References

• 1 Benitez RP, Silva MT, Klem J, Veznedaroglu E, Rosenwasser RH. Endovascular occlusion of wide-necked aneurysms with a new intracranial microstent (Neuroform) and detachable coils. Neurosurgery 2004; 54 (06) 1359-1367 discussion 1368
• 2 Biondi A, Janardhan V, Katz JM, Salvaggio K, Riina HA, Gobin YP. Neuroform stent-assisted coil embolization of wide-neck intracranial aneurysms: strategies in stent deployment and midterm follow-up. Neurosurgery 2007; 61 (03) 460-468 discussion 468–469
• 3 Aydin K, Arat A, Sencer S, Barburoglu M, Men S. Stent-assisted coiling of wide-neck intracranial aneurysms using low-profile LEO baby stents: initial and midterm results. AJNR Am J Neuroradiol 2015; 36 (10) 1934-1941
• 4 Poncyljusz W, Biliński P, Safranow K. et al. The LVIS/LVIS Jr. stents in the treatment of wide-neck intracranial aneurysms: multicentre registry. J NeuroIntervent Surg 2015; 7 (07) 524-529
• 5 Ulfert C, Pham M, Sonnberger M. et al. The Neuroform Atlas stent to assist coil embolization of intracranial aneurysms: a multicentre experience. J Neurointerv Surg 2018; 10 (12) 1192-1196
• 6 Cay F, Peker A, Arat A. Stent-assisted coiling of cerebral aneurysms with the Neuroform Atlas stent. Interv Neuroradiol 2018; 24 (03) 263-269
• 7 Mascitelli JR, Moyle H, Oermann EK. et al. An update to the Raymond-Roy occlusion classification of intracranial aneurysms treated with coil embolization. J Neurointerv Surg 2015; 7 (07) 496-502
• 8 Piotin M, Blanc R, Spelle L. et al. Stent-assisted coiling of intracranial aneurysms: clinical and angiographic results in 216 consecutive aneurysms. Stroke 2010; 41 (01) 110-115
• 9 Lawson MF, Newman WC, Chi YY, Mocco JD, Hoh BL. Stent-associated flow remodeling causes further occlusion of incompletely coiled aneurysms. Neurosurgery 2011; 69 (03) 598-603 discussion 603–604
• 10 Chalouhi N, Jabbour P, Singhal S. et al. Stent-assisted coiling of intracranial aneurysms: predictors of complications, recanalization, and outcome in 508 cases. Stroke 2013; 44 (05) 1348-1353
• 11 Irie R, Suzuki M, Yamamoto M. et al. Assessing blood flow in an intracranial stent: a feasibility study of MR angiography using a silent scan after stent-assisted coil embolization for anterior circulation aneurysms. AJNR Am J Neuroradiol 2015; 36 (05) 967-970
• 12 Cho WS, Kim SS, Lee SJ, Kim SH. The effectiveness of 3T time-of-flight magnetic resonance angiography for follow-up evaluations after the stent-assisted coil embolization of cerebral aneurysms. Acta Radiol 2014; 55 (05) 604-613