Stent-assisted coil embolization of challenging intracranial aneurysms: initial and mid-term results with low-profile ACCLINO devices

Türeli, Derya; Sabet, Soheil; Şenol, Serkan; Andaç, Nurten; Dönmez, Halil; Geyik, Serdar; Baltacıoğlu, Feyyaz; Çekirge, Saruhan

doi:10.1007/s00701-016-2839-8

Cited by 17 publications

(9 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In three retrospective studies published on the outcome of the CC Acclino stent and a larger contemporary series regarding the smaller BR stents (Leo Baby and LVIS Jr), the rate of death or permanent neurologic complications ranged from 0% to 7% and 2.4% to 3.8%, respectively. 15,22–26 Although the rate of acceptable (RRS 1 and 2) aneurysm occlusion in our study was similar to the results reported in these manuscripts, the rate of neck remnants at final follow-up was higher in our study. One plausible explanation for this discrepancy may be the larger pore size and gator backing, which are known characteristics of the OC design.…”

Section: Discussionsupporting

confidence: 90%

“…It is unlikely that the Atlas stent has a considerable flowdiverting effect. Another explanation is that a portion of patients were treated with dual (X, Y, telescopic) stenting in these series, as well as with other devices during the same session (e.g., balloons and intrasaccular flow diverters in the reports on Acclino stents), 22,24 which increased the angiographic occlusion rate in these reports and precluded a pure assessment of the effects of the specific stent.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Stent-assisted coiling of cerebral aneurysms with the Neuroform Atlas stent

2018

View full text Add to dashboard Cite

Objectives The Neuroform Atlas stent (AS) is the smallest intracranial stent with an open-cell design. This study reports the first clinical experience with AS. Methods All intracranial aneurysms treated by stent-assisted coiling using a single AS in a single institution were retrospectively evaluated. Patient demographics, aneurysm characteristics, angles between the parent artery and stented branch, technical success, and clinical and angiographic follow-up were analyzed. Results Fifty-five consecutive aneurysms treated with AS-assisted coiling were included. Of these, 69.1% were located distal to the circle of Willis. Technical success rate was 100%. The mean diameters of proximal and distal parent arteries were 2.62 mm (range 1.5–4.4) and 1.8 mm (range 0.8–3.5), respectively. Except for a minor stroke in a patient who completely discontinued antiplatelet therapy on postoperative day 4, there were no clinical events with permanent sequelae, and 94.1% of patients had Raymond-Roy score of 1 or 2 aneurysmal occlusion at a mean follow-up duration of 7.9 months. Although the angle between the parent artery and the stented branch increased significantly ( p < 0.001) with time, the angular change at follow-up was only 16.45 ± 11.03 degrees and was inversely correlated both with preoperative angle and the diameter of the distal parent artery ( r = −0.465 and r = −0.433, respectively, p = 0.004 for both). Conclusion AS-assisted coiling was associated with a favorable early clinical outcome and angiographic results in this series. This stent can be used for distally located aneurysms and results in minimal alteration of the arterial anatomy.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Stent-assisted coiling of cerebral aneurysms with the Neuroform Atlas stent

2018

View full text Add to dashboard Cite

show abstract

“…In our series, immediate complete obliteration (RROC I-II) was achieved in 89.6% of the cases, similar to what has been described by Behme et al [5]. Table 3 summarizes the largest cases series (≥2 cases) describing Y-stentassisted coil embolization [4,5,[14][15][16][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”

Section: Discussionsupporting

confidence: 61%

“…The authors emphasize the closed-cell design of the Acclino stent with an electropolished surface, which theoretically decreases thrombogenicity. However, this design decreases stent conformability and enhances angular remodeling [15]. Similarly, Kabbasch et al [16] described 3 cases of Y-stenting with the Acclino stent, with a 33% complication rate: 1 IST, which resolved with IA GPIs.…”

Section: Discussionmentioning

confidence: 99%

“…The authors underlined the advantages of these braided stents over other lasercut open-and closed-cell stents (Enterprise, Neuroform, and Solitaire [Medtronic]), mainly better wall apposition and scaffolding. Tureli et al [15] described 11 Y-stenting procedures with the Acclino stent with an 18% complication rate. The authors emphasize the closed-cell design of the Acclino stent with an electropolished surface, which theoretically decreases thrombogenicity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

LVIS Jr Device for Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms: A Multicenter Experience

et al. 2018

View full text Add to dashboard Cite

Background and Purpose: Complex wide-neck intracranial aneurysms are challenging to treat. We report a multicenter experience using the LVIS Jr stent for “Y-stent”-assisted coiling embolization of wide-neck bifurcation aneurysms. Methods: Seven centers provided retrospective data on patients who underwent Y-stenting. Technical complications, immediate posttreatment angiographic results, clinical outcomes, and imaging follow-up were assessed. Results: Thirty patients/aneurysms were treated: 15 basilar tip, 8 middle cerebral artery, 4 anterior communicating artery, 1 pericallosal, and 2 posterior inferior cerebellar artery aneurysms. The mean aneurysm size was 11 mm and the mean dome-to-neck ratio was 1.3 mm. Twenty-four aneurysms were unruptured and treated electively, and 6 were acutely ruptured. Fifty-eight LVIS Jr stents were successfully deployed without any technical issue. One procedural and transient in-stent thrombosis resolved with the intravenous infusion of a glycoprotein IIb/IIIa inhibitor. Five periprocedural complications (within 30 days) occurred: 2 periprocedural neurological complications (1 small temporal stroke that presented with transient aphasia and 1 posterior cerebral artery infarct) and 3 nonneurological periprocedural complications (2 retroperitoneal hematomas, and 1 patient developed a disseminated intravascular coagulopathy). One permanent complication (3.3%) directly related to Y-stenting was reported in the patient who suffered the posterior cerebral artery infarct. Immediate complete obliteration (Raymond-Roy Occlusion Classification [RROC] I–II) was achieved in 26 cases (89.6%). Twenty-four patients had clinical and imaging follow-up (mean 5.2 months). Complete angiographic occlusion (RROC I–II) was observed in 23 patients (96%). A good functional outcome with a modified Rankin Scale score ≤2 was achieved in 26 cases. Conclusions: In this multicenter case series, Y-stent-assisted coiling of wide-neck aneurysms with the LVIS Jr device was feasible and relatively safe. Follow-up imaging demonstrated very low recanalization rates.

show abstract