Safety and efficacy of Neuroform Atlas stent assisted coil embolization of intracranial wide-necked aneurysms
10.3760/cma.j.cn115354-20240821-00500
- VernacularTitle:Neuroform Atlas支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤的安全性及有效性研究
- Author:
Xiheng CHEN
1
;
Hailong ZHANG
;
Mingtao LI
;
Dong LIU
;
Lixin MA
;
He LIU
;
Ming LYU
;
Yang WANG
Author Information
1. 首都医科大学附属北京朝阳医院神经外科，北京 100020
- Keywords:
Neuroform Atlas stent;
Coil;
Wide-neck aneurysm;
Complication;
Endovascular treatment
- From:
Chinese Journal of Neuromedicine
2024;23(10):992-998
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the safety and efficacy of Neuroform Atlas stent assisted coil embolization in intracranial wide-necked aneurysms, and analyze the risk factors for procedure-related complications.Methods:A retrospective analysis was performed; the clinical data of 367 patients with 374 intracranial wide-necked aneurysms accepted Neuroform Atlas stent assisted coil embolization from January 2021 to February 2024 were collected. Clinical prognosis, immediate postoperative and 6-12 months postoperative angiography, and procedure-related complications (including perioperative complications and complications during follow-up) were analyzed. Univariate and multivariate Logistic regression analyses were used to identify the independent risk factors for procedure-related complications.Results:Immediate postoperative Raymond-Roy Occlusion Classification (RROC) grading I was noted in 323 aneurysms (86.4%), grading II in 42 aneurysms (11.2%), and grading III in aneurysms (2.4%). Perioperative complications occurred in 26 patients (7.1%): 19 (5.2%) were ischemic complications, while 7 (1.9%) were hemorrhagic complications. A total of 260 aneurysms (69.5%) underwent follow-up angiography, including 229 aneurysms (88.1%) with RROC grading I, 25 aneurysms (9.6%) with grading II and 6 aneurysms (2.3%) with grading III. During the follow-up, 5 patients (1.9%) developed stent stenosis, but only 1 patient had transient ischemic attack, and all of them had boundless vessel occlusion. At the last follow-up, 10 patients (2.7%) had poor prognosis, including 8 (2.2%) with severe disabilities (7 with modified Rankin Scale [mRS] scores of 3 and 1 with mRS scores of 4), and 2 (0.5%) deaths (mRS scores of 6). Multivariate Logistic regression analysis showed that large aneurysms and posterior circulation aneurysms were independent risk factors for procedure-related complications ( OR=6.299, 95% CI: 1.131-35.094, P=0.036; OR=3.654, 95% CI: 1.478-9.035, P=0.005). Conclusion:Neuroform Atlas stent assisted coil embolization in intracranial wide-necked aneurysms is safe and feasible; patients with large aneurysms and posterior circulating aneurysms are more likely to have procedure-related complications.
