Initial experience and one-year follow-up with Neuroform Atlas Stent System for the treatment of brain aneurysms.

Abstract

The Neuroform Atlas Stent System is a recently introduced modification of the original Neuroform Stent System consisting of a hybrid design with open and closed cells. Initial experience, technical considerations and treatment outcomes including 1-year follow-up using the Atlas stent in combination with coil embolization are reported. Thirty patients with 30 unruptured aneurysms were treated with stent reconstruction. Immediate, 4-month and 12-month post-treatment angiography and clinical assessment were performed. In 29 cases, the stents were delivered and positioned without difficulty in deployment. Technical complications occurred in one patient related to advancement of the stent during delivery. One procedure-related clinical complication occurred with no permanent neurological deficit. On immediate post-treatment angiography, 29 of 30 aneurysms showed Raymond Class I or Class II occlusion. At 1-year follow-up, all 30 patients were clinically stable and 18 of 30 aneurysms showed Raymond Class I complete occlusion. Retreatment was performed in two patients with residual aneurysm. The Atlas stent is technically safe and simple to implant and has a low thrombogenic potential. We experienced fewer problems associated with deployment and implantation, thromboembolic complications and hemorrhagic events compared with other types of stents, including braided stents. However, because of its low thrombogenic potential, partially occluded aneurysms or those with aneurysm remnants do not progress to complete occlusion.