Abstract WP119: Stent-Assisted Coiling of Intracranial Aneurysms With the Neuroform ATLAS Stent: Immediate and Midterm Angiographic and Clinical Follow-Up

Abstract

Object: Self-expandable stents have broadened the spectrum of endovascular treatment of intracranial aneurysms. The Neuroform ATLAS, the evolution of Neuroform EZ, is a nitinol self-expanding hybrid/open-cell stent, which can be delivered through a low-profile 0.017 inch catheter. We present our experience in the treatment of intracranial aneurysms with this stent. Methods: We prospectively maintained a database from consecutive patients who underwent stent-assisted coiling with Neuroform ATLAS from July 2015 to July 2018. Clinical and angiographic results were analyzed. Results: Ninety-one patients harboring 95 aneurysms were treated in 95 procedures. A single stent was used in 42 (44.2%) cases, while 52 (54.7%) aneurysms were treated with 2 stents (50 “Y” configuration, 2 “X” configuration). One case of Y stent-assisted coiling was prematurely interrupted because of aneurysm perforation. Post-treatment control angiography showed complete occlusion in 55 cases (58.5%), neck remnant in 15 cases (15.9%), incomplete occlusion in 24 cases (25.5%). The overall symptomatic peri-procedural complication rate was 13.7%. The overall morbidity rate was 4.2% (4 cases with a modified Rankin Scale >2 and <6). The overall mortality rate was 2.1% (2 cases). Fifty-six aneurysms underwent follow-up (mean follow-up: 10.5 months): 47 aneurysms (83.9%) were completely occluded, 7 aneurysms (12.5%) had a neck remnant, and 2 aneurysms (3.6%) was incompletely occluded. Conclusion: The Neuroform ATLAS is an effective device for treatment of complex intracranial aneurysms, allowing good conformability and high level of navigability, but with a non-negligible rate of complications.