Midterm Outcomes After Low-Profile Visualization Endoluminal Support or Atlas Stent-Assisted Coiling of Intracranial Aneurysms: A Propensity Score Matching Analysis.

Abstract

The interplay of various commercially available stents during coil embolization of intracranial aneurysms and their ultimate impact are subject to debate. To compare midterm outcomes of Low-Profile Visualization Endoluminal Support (LVIS) (MicroVention Inc) and Atlas (Stryker) stent-assisted coiling procedures. A total of 459 intracranial aneurysms subjected to coil embolization using LVIS (n=318) or Atlas stents (n=141) between April 2015 and December 2019 were eligible for study. To assess occlusive status postembolization, magnetic resonance angiography and/or conventional angiography were used. The Raymond classification was applied to categorize recanalization. Our analysis was propensity score matched according to probability of stent type deployed. Eventually, 41 aneurysms (8.9%) displayed recanalization (minor, 28; major, 13) 6 mo after coiling. Patient age (P=.018), sex (P=.015), aneurysmal location (P<.001), and type of aneurysm (P<.001) differed significantly by group. Overall and major recanalization rates at midterm were similar in both groups (9.1% and 8.5%vs 3.1% and 2.1%, respectively), and there was no significant difference even after 1:1 propensity score matching (odds ratio [OR]=0.75 [P=.514] and OR=0.75 [P=.706], respectively). In stent-assisted coil embolization of intracranial aneurysms, midterm outcomes of LVIS and Atlas device groups were similar, despite theoretic LVIS superiority. Further randomized comparative studies are needed to confirm our findings.