Initial and mid-term results of LEO Baby stent-assisted coiling of intracranial aneurysms located in small arteries: A single-center experience with 131 consecutive patients

Abstract

Background and purposeLow-profile intracranial stents such as the LEO Baby stents are considered to be advantageous for the treatment of intracranial aneurysms originating from small arteries. This study aimed to evaluate the initial and mid-term clinical and angiographic results of LEO Baby stents in stent-assisted coiling of intracranial aneurysms with small parent arteries (<2.5 mm).MethodsWe performed a retrospective study to identify 131 patients with aneurysms arising from small parent arteries treated with Leo Baby stent-assisted coiling in a single institution between October 2018 and June 2021. We assessed the immediate and progressive aneurysm occlusion rates, procedure-related complications, and clinical outcomes.ResultsA total of 131 patients with 135 aneurysms were identified, including 65 (48.1%) cases of acutely ruptured aneurysms. Technical success was achieved in all cases (100%). The immediate angiography showed complete occlusion in 111 aneurysms (82.2%), neck remnants in 19 (14.1%), and residual sac in 5 (3.7%). Procedure-related complications occurred in 14 cases (10.3%), including 13 (9.6%) thromboembolic complications and 1 (0.7%) hemorrhagic complication. Six-month follow-up angiography was achieved in 106 (78.5%) aneurysms, which showed complete occlusion in 102 (96.2%) aneurysms, neck remnants in 2 (1.9%), and residual sac in 2 (1.9%). Clinical follow-up was available in all patients with a median duration of 6.8 months, and favorable clinical outcomes (modified Rankin Scale score: 0–2) reached 91.6%. The mortality rate was 4.6%.ConclusionOur results demonstrate that stent-assisted coiling of intracranial aneurysms located on small arteries using LEO Baby stents is technically feasible, highly effective, and has midterm durability in aneurysmal occlusion.

Predictors of Perioperative Complications During Leo Baby Stent Treatment for Acutely Ruptured Intracranial Aneurysms: A Retrospective Multicenter Study

“…The periprocedural complication rate was 12.4%. Immediate postoperative angiography in the study by Shen et al 6 with 135 aneurysms (48.1% ruptured aneurysms) from small arteries treated with Leo Baby showed 82.2% of aneurysms rated as Raymond I. The rate of complete occlusion in the follow-up results increased to 95.7%, similar to our study.…”

Use of the Neuroform Atlas stent for wide-necked cerebral aneurysms

“…In a study investigating the effects of the Enterprise 2 stent in 106 wide-necked aneurysms in 106 patients by Zhou et al 17 , the stent was successfully deployed in all patients, perioperative complications occurred in 10 patients (9.4%) (including cerebral infarction in 6), follow-up angiographic aneurysm occlusion was satisfactory (Raymond grades I and II) in 89 (93.7%), and poor clinical outcome (mRS ≥ 3) at the last follow-up was seen in seven patients. In a study exploring the effect of the Leo Baby stent (Balt Extrusion, Montmorency, France) for assisted coiling in 131 patients with 135 aneurysms 19 , the technical success was achieved in all cases (100%), complete occlusion was obtained in 111 aneurysms (82.2%), neck remnants in 19 (14.1%), and residual sac in 5 (3.7%) immediately after embolization. Procedure-related complications occurred in 14 cases (10.3%), including 13 (9.6%) thromboembolic complications and 1 (0.7%) hemorrhagic complication.…”