Neuroform Atlas stent-assisted coiling of ruptured intracranial aneurysms: A multicenter study

Russo, Riccardo; Bradač, Gianni Boris; Castellan, Lucio; Gallesio, Ivan; Garbossa, Diego; Iannucci, Giuseppe; Mardighian, Dikran; Menozzi, Roberto; Pitrone, Antonio; Romano, Giuseppe; Venturi, Fabrizio; Bergui, Mauro

doi:10.1016/j.neurad.2020.02.006

Cited by 22 publications

(13 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A series of 61 patients undergoing stent-assisted coiling in ruptured intracranial aneurysms in Italy used anti-Gp IIb/IIIa inhibitors only if stent thrombosis was noted at the time of treatment. Acute stent thrombosis occurred in 36% of patients (22/61) in this series and patients received anti-Gp IIb/IIIa treatment—either abciximab (15) or tirofiban (seven)—with no increase in hemorrhage or overall complication rate in those patients 20. This rate is consistent with previously-reported rates of hemorrhagic complications during flow diversion or stent-assisted coiling 10.…”

Section: Discussionsupporting

confidence: 86%

Use of intravenous cangrelor in the treatment of ruptured and unruptured cerebral aneurysms: an updated single-center analysis and pooled analysis of current studies

Entezami

Dalfino

Boulos

et al. 2022

J NeuroIntervent Surg

View full text Add to dashboard Cite

BackgroundIntracranial stent placement for the treatment of cerebral aneurysms is increasingly utilized in both ruptured and unruptured scenarios. Intravenous (IV) cangrelor is a relatively new antiplatelet agent that was initially approved for coronary interventions. In addition to our institution, five other centers have published their results using IV cangrelor in neurointerventional procedures. This article combines the aneurysm treatment data from all prior studies to provide insight into the safety and efficacy of cangrelor for intracranial aneurysm treatment.MethodsA prospectively maintained database was reviewed to identify all cases of IV cangrelor administration during aneurysm embolization. 20 additional patients were identified who had not been previously published. In addition, a literature search was performed to identify prior publications regarding cangrelor in neurointervention. The data from these were combined with our institutional results in a pooled-analysis.ResultsOverall, 85 patients who received IV cangrelor during aneurysm embolization were identified, including 46 ruptured and 39 unruptured cases. The asymptomatic and symptomatic intracranial hemorrhage rates were 4% (2/46) for ruptured cases and 2.6% (1/39) for unruptured cases. The rate of retroperitoneal hematoma and gastrointestinal bleeding was 0%. There were no incidents of intraprocedural thromboembolic complication or intraprocedural in-stent thrombosis in either cohort. One subject suffered an ischemic stroke at 24 hours secondary to in-stent thrombosis in a ruptured case.ConclusionsIV cangrelor during aneurysm embolization appears to be safe, with a symptomatic intracranial hemorrhage rate of 4% in ruptured cases and 2.6% in unruptured cases. More research is needed to determine the ideal dosing regimen.

show abstract

Section: Discussionsupporting

confidence: 86%

Use of intravenous cangrelor in the treatment of ruptured and unruptured cerebral aneurysms: an updated single-center analysis and pooled analysis of current studies

Entezami

Dalfino

Boulos

et al. 2022

J NeuroIntervent Surg

View full text Add to dashboard Cite

show abstract

“…Xue et al reported an ischemic complication rate of 7.5% (3/40) in a study using LVIS stent-assisted embolization to treat ruptured middle cerebral aneurysms ( 24 ). In a study of acute treatment of ruptured aneurysms using Atlas stents, Russo et al reported 22 cases of acute thrombosis in 61 patients, with an incidence of 36.1% ( 25 ). This is contrary to our conventional belief that laser stents have a lower incidence of thrombosis compared to braided stents.…”

Section: Discussionmentioning

confidence: 99%

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

Shen

Ni²,

Li³

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

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.

show abstract

“…We can infer the important role of the IFD-AC in ruptured aneurysms looking at the results of the SAC [ 25 , 26 ]. In ruptured cases the SAC has a high occlusion rate, but the overall complication rate is not negligible (≈20%), and the safety of the proper antiplatelet therapy needed for stenting has not been evaluated in the acute setting.…”

Section: Discussionmentioning

confidence: 99%

Intrasaccular Flow Disruptor-Assisted Coiling of Intracranial Aneurysms Using the Novel Contour Neurovascular Systems and NEQSTENT: A Single-Center Safety and Feasibility Study

et al. 2022

View full text Add to dashboard Cite

Background: Intrasaccular flow disruptors (IFD) have been introduced in the treatment of intracranial aneurysms (IAs) to overcome the low aneurysm occlusion rate and the high recanalization rate of the coiling technique. Among them, the Contour Neurovascular System (CNS) and the Neqstent (NQS) were designed to reconstruct the aneurysmal neck and both can be used as assisting coiling devices. We aimed to report our preliminary experience with the flow disruptor-assisted coiling (IFD-AC) technique. Methods: We performed a retrospective analysis of prospectively collected data of all patients with IAs treated with the IFD-AC. Results: Between February 2021 and April 2022, we treated 15 IAs with the IFD-AC: 10 ruptured and 5 unruptured. The IFD-AC was successfully performed in 13 cases, with a post-operative RROC 1 in 12 cases (92.3%) and RROC 2 in 1 case (7.7%). There was one ischemic event (6.7%) and no hemorrhagic complications. Twelve patients underwent a mid-term radiologic follow-up: Ten IAs (83.4%) presented an adequate occlusion, while 2 (16.7%) had a recurrence. Conclusions: The IFD-AC, both with the CNS and the NQS, seems a safe technique with promising efficacy profile. The IFD-AC has proved to be safe without antiplatelet therapy in ruptured cases. Further studies are needed to confirm our preliminary results.

show abstract

Neuroform Atlas stent-assisted coiling of ruptured intracranial aneurysms: A multicenter study

Cited by 22 publications

References 30 publications

Use of intravenous cangrelor in the treatment of ruptured and unruptured cerebral aneurysms: an updated single-center analysis and pooled analysis of current studies

Use of intravenous cangrelor in the treatment of ruptured and unruptured cerebral aneurysms: an updated single-center analysis and pooled analysis of current studies

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

Intrasaccular Flow Disruptor-Assisted Coiling of Intracranial Aneurysms Using the Novel Contour Neurovascular Systems and NEQSTENT: A Single-Center Safety and Feasibility Study

Contact Info

Product

Resources

About