Endovascular Treatment of Cerebral Aneurysms Using the Leo Stent: Long-Term Follow-Up and Expansion of Indications

Abstract

The authors share their extended experience using the Leo stent. Building on their earlier work, they present more cases, a longer follow-up period, and expansion of indications for use of the stent. A total of 71 patients with 75 aneurysms were included in this study. 61 saccular and broadnecked intracranial aneurysms and twelve fusiform lesions were treated electively. Stent deployment was successful for 98% of the saccular aneurysms. Initial complete obliteration was achieved in 26 saccular aneurysms, a neck remnant in six, a residual aneurysm in four, while no immediate coil embolization was chosen for 25. Angiographic follow-up after 11 months available for 56 saccular aneurysms revealed unaffected parent arteries in 94%. Eleven saccular aneurysms exhibited spontaneous thrombosing after stent deployment without coiling and four lesions had recanalized (three residual aneurysms, one neck remnant). Regarding long-term follow-up ≥ 12 months, available for 26 saccular aneurysms, none of them showed parent artery affection. A recanalization was evident in three saccular aneurysms. All stents were successfully deployed for the fusiform aneurysms. Three patients with large fusiform aneurysms of the basilar artery had a lethal outcome. No clinical complications occurred in the remaining cases. The authors confirmed the efficacy of the Leo stent for the treatment of saccular and broad-necked intracranial aneurysms. Mid- and long-term follow-up demonstrated intact parent vessels and stable occlusion rates in the majority of patients. This device is a treatment option for fusiform lesions, but may confer a higher periprocedural risk.