The low-profile Neuroform Atlas stent in the treatment of wide-necked intracranial aneurysms - immediate and midterm results: An Italian multicenter registry
The low-profile Neuroform Atlas stent in the treatment of wide-necked intracranial aneurysms - immediate and midterm results: An Italian multicenter registry
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DOI：
10.1016/j.neurad.2019.03.005
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发表时间：
2020-11-01
影响因子：
3.5
通讯作者：
Vinci, Sergio L.
中科院分区：
文献类型：
--
作者：
Caragliano, Antonio A.;Papa, Rosario;Vinci, Sergio L.
背景和目的。 - 宽颈脑动脉瘤的治疗对于神经介入医生来说仍然是一个挑战，主要是因为它的高复发率。低轮廓支架使这些动脉瘤的治疗成为可能。在我们的多中心系列中，我们分析了 Neuroform Atlas 支架辅助盘绕的临床和血管造影结果。材料和方法。 - 2016年1月至2017年3月，通过CTA、MRA和DSA发现113个宽颈动脉瘤。 Atlas 支架辅助盘绕手术是在全身麻醉下采用顺序或监禁技术进行的。进行六个月的随访 DSA，通过改良 Raymond-Roy 闭塞量表 (RROC) 评估复发率。此外，根据mRS对患者进行临床评估，分析残疾程度。 12 个月时进行 MRI 评估脑组织和血管。结果。 - 在所有手术中，将 Neuroform Atlas 导航至目标血管并将支架部署在动脉瘤颈上是可行的。术中并发症占6.2%（7/113）。立即闭塞率为 RROC 1（88%）、2（9%）和 3（3%）。 6个月的临床数据显示，96.5%的患者mRS评分为0-1； 3例患者死于SAH相关并发症。 12 个月的随访显示，82% 的病例中 RROC 为 1，13% 的病例为 2，5% 的病例为 3。没有动脉瘤被消退。结论。 - 根据我们的多中心经验，Neuroform Atlas 支架辅助盘绕已被证明是治疗宽颈颅内动脉瘤的一种安全有效的技术，并具有令人鼓舞的临床和血管造影结果。 (C) 2019 Elsevier Masson SAS。版权所有。
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. (C) 2019 Elsevier Masson SAS. All rights reserved.