Single Center Experience in Stent-Assisted Coiling of Complex Intracranial Aneurysms Using Low-Profile Stents : The ACCLINO® Stent Versus the ACCLINO® Flex Stent.

Abstract

The introduction of low-profile stent systems has broadened and facilitated the treatment of complex intracranial aneurysms. This retrospective case series study was conducted to assess and compare the clinical and angiographic outcomes of patients with complex intracranial aneurysms who were treated with ACCLINO®(AS) and ACCLINO® flex stents(AFS). In 85patients (female 61; male 24) atotal of 95complex intracranial aneurysms, 71 (74.7%) in the anterior circulation and 24 (25.3%) in the posterior circulation were treated. Angiographic and clinical data, aneurysm characteristics and follow-up results were analyzed. The AS was used in 47cases (49.5%) and the AFS in 48cases (50.5%). Initial angiography after the intervention showed acomplete occlusion in 52.6% (Raymond-Roy occlusion classification [RROC]1), aneck remnant in 38.9% (RROC2) and an incomplete occlusion in 8.4% (RROC3). Follow-up (AS: 25.2 ± 15.4months; AFS: 9.6 ± 8.0months) revealed an occlusion rate of 70.5% (RROC1), 27.4% (RROC2) and 2.1% (RROC3). There was no statistically significant difference between the initial (p = 0.484) and the follow-up occlusion rate (p = 0.284) when comparing the two devices. Recoiling was performed in 8cases (8.4%). The overall complication rate was 9.5% with 5strokes (5.3%), 2hemorrhages (2.1%), 1in-stent stenosis (1.1%), 1stent occlusion (1.1%) and 2stent thromboses (2.1%). There was no procedure-related mortality. Using the ACCLINO® and ACCLINO® flex stent system is afeasible and effective procedure with an acceptable safety profile. Initial and follow-up angiographic results were satisfactory.