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

Çay, Ferdi; Peker, Ahmet; Arat, Anıl

doi:10.1177/1591019917753710

Cited by 49 publications

(41 citation statements)

References 33 publications

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“…of recurrent aneurysms with the latest generation of mini intracranial stents in distal bifurcation aneurysms (1,3,5). Moreover, the rate of obliteration for the 3 aneurysms managed using flow diversion (1 with telescopic stenting and 2 with FDs) is also concordant with the lower rates of total occlusion following flow diversion for bifurcation aneurysms (18).…”

Section: █ Conclusionmentioning

confidence: 75%

Endovascular treatment of superior cerebellar artery aneurysms

Açık

Dağlıoğlu²,

Akmangit³

et al. 2019

Turkish Neurosurgery

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AIM: To present our experience on superior cerebellar artery (SCA) aneurysms treated with embolization by using current endovascular techniques. MATERIAL and METHODS: All SCA aneurysms treated by our endovascular team since 2013 were retrospectively evaluated. Clinical information and angiographic findings on presentation, during treatment and on follow-up were noted. RESULTS: Endovascular treatment was the primary treatment method for SCA aneurysms during the study period. Twenty three patients (15 female, 8 male) with a mean age of 50.6 years, 12 of whom with subarachnoid hemorrhage were treated. Treatments included coiling (56%), stent assisted coiling, stentriever assisted coiling, Y stent assisted coiling and flow diversion with either flow diverter placement or telescopic stenting. Two patients died secondary to consequences of subarachnoid hemorrhage. The outcome of 1 patient was Modified Rankin Scale (mRS) 3 and the outcome of remaining 20 patients was mRS 0. The rates of aneurysm occlusion according to Raymond-Roy classification were: class 1 in 11 patients, class 2 in 6 patients and class 3 in 2 patients on a mean follow-up of 15.3 months. Only one patient required retreatment. CONCLUSION: Current endovascular techniques are able to address the high rate of recanalization and retreatment of SCA aneurysms which are currently the major drawbacks associated with primary coiling when compared with surgical treatment. It remains to be shown if use of these latest techniques are associated with increased risk of thromboembolic events.

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Section: █ Conclusionmentioning

confidence: 75%

Endovascular treatment of superior cerebellar artery aneurysms

Açık

Dağlıoğlu²,

Akmangit³

et al. 2019

Turkish Neurosurgery

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“…This may be due to the better flexibility of the latter stent. [ 36 ] In addition, due to the open-cell design of this stent, we believe it results in better wall apposition.…”

Section: Discussionmentioning

confidence: 99%

The exchange-free technique: A novel technique for enhancing surpass flow diverter placement

Öcal

Arat

2020

Asian J Neurosurg

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Background: Following flow diverter placement, approximately 20% of intracranial aneurysms remain as residual aneurysms at 1 year. Device malapposition is a cause of residual aneurysms after flow diversion. We present a new and straightforward technique (exchange-free technique [EFT]) to enhance apposition of the surpass flow diverter (SFD), the only over-the-wire flow diverter currently available. Materials and Methods: We deployed laser-cut mini stents through the inner deployment catheter of the SFD. This maneuver was performed simply by withdrawing the micro-guidewire from its lumen and replacing it with a mini-stent (stents deliverable through microcatheters with inner diameter of 0.0165 inches), without a need to re-cross the deployed SFD or an exchange maneuver. All aneurysms in which this technique was utilized were retrospectively reviewed. Results: Twenty-eight patients (20 females) with 30 treated aneurysms were identified. The mean aneurysm diameter was 10.2 ± 6.6 mm. Technical success rate was 96.6% (29/30 aneurysms). There was no mortality or permanent morbidity related to the procedures. Except for the patient treated for an iatrogenic, surgery-related internal carotid artery pseudoaneurysm who died secondary to consequences of multiple surgeries, no cases of mortality or permanent morbidity were noted. Complete aneurysm occlusion rates were 78.2%, 82.1%, and 95.2% at 0–3, 3–6, and 9–12 months, respectively. None of the patients were re-treated. Conclusion: EFT is a simple and fast technique which was not associated with adverse effects in our series. The higher aneurysm obliteration rate obtained with EFT is probably the result of better wall apposition of the SFD.

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“…The stents used for assisting coiling were initially coronary stents, the open-cell Neuroform stent introduced in 2002, the open-cell and braided intracranial Leo stent (Balt, Montmorency, France), the closed-cell Enterprise (Codman, Raynham, Massachusetts, United States), and the Solitaire (Covidien, Irvine, California, United States) stents. [22][23][24] The LVIS stent is a novel, self-expandable braided stent with closed-cell design of nitinol material 24 that has a metal coverage much greater than the conventional Enterprise or Neuroform stents but slightly less than the Pipeline flow diverter. Tiny intracranial aneurysms can be safely and effectively treated with the LVIS stent in comparison with coiling alone.…”

Section: Discussionmentioning

confidence: 99%

“…Tiny intracranial aneurysms can be safely and effectively treated with the LVIS stent in comparison with coiling alone. 25 In studies comparing the Enterprise, Neuroform, Solitaire, or LVIS stent, no significant difference was revealed in the final clinical outcomes in patients treated with any of these stents versus the other, 22 but some specific complications may be associated with specific, different designs of these stents.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Retreatment of Cerebral Aneurysms Previously Treated with Endovascular Embolization

Gao

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Objective Intracranial aneurysms treated with endovascular coil embolization may recur. We investigated the factors affecting aneurysmal recurrence after embolization and effects of endovascular retreatment within 1 year. Methods In 3 years, 1,335 patients with 1,385 intracranial aneurysms were treated with coil embolization. Factors affecting aneurysm recurrence and the effects of endovascular retreatment were analyzed. Results Angiography immediately following embolization showed total occlusion in 1,030 aneurysms (74.4%), neck remnant in 207 (14.9%), and partial occlusion in 148 (10.7%), with a total peri-procedure complication rate of 4.2%. Overall, 145 patients with 151 aneurysms recurred within 1 year and the other 1,234 aneurysms remained occluded (89.1%). A significant (p < 0.05) difference existed in aneurysm size, rupture status, use of stent and immediate occlusion outcome between the two groups, with significantly (p < 0.05) lower recurrence rates in aneurysms with smaller sizes, no rupture and stent-assistance coiling. Neck remnant, partial occlusion, coiling without stent assistance, large and giant aneurysms were significant (p < 0.05) risk factors for aneurysm recurrence during the first year. The rate of recurrence was 4.7% (11/232) in aneurysms with total occlusion and 35.9% (23/64) in aneurysms with neck remnant and partial occlusion. Of the 34 recurrent aneurysms, 6 were re-embolized with detachable coils alone, 12 with stent-assisted coiling, 8 with balloon-assisted embolization, and the remaining 8 aneurysms with covered stents, resulting in total occlusion in 28 aneurysms and neck remnant in 6. Conclusion Recurrence of previously-coiled cerebral aneurysms is significantly affected by aneurysm size, use of stent and degree of immediate occlusion. Endovascular retreatment with balloon-or stent-assisted techniques or with covered stents can be safe and effective for recurrent cerebral aneurysms.

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

Cited by 49 publications

References 33 publications

Endovascular treatment of superior cerebellar artery aneurysms

Endovascular treatment of superior cerebellar artery aneurysms

The exchange-free technique: A novel technique for enhancing surpass flow diverter placement

Endovascular Retreatment of Cerebral Aneurysms Previously Treated with Endovascular Embolization

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